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. 2020 Apr;162(4):893-903.
doi: 10.1007/s00701-020-04235-7. Epub 2020 Feb 4.

The burden of headache following aneurysmal subarachnoid hemorrhage: a prospective single-center cross-sectional analysis

Torge Huckhagel  1 , Regine Klinger  2 , Nils Ole Schmidt  3 , Jan Regelsberger  3 , Manfred Westphal  3 , Patrick Czorlich  3
Affiliations

The burden of headache following aneurysmal subarachnoid hemorrhage: a prospective single-center cross-sectional analysis

Torge Huckhagel et al. Acta Neurochir (Wien). 2020 Apr.

Abstract

Background: Aneurysmal subarachnoid hemorrhage (SAH) as a serious type of stroke is frequently accompanied by a so-called initial thunderclap headache. However, the occurrence of burdensome long-term headache following SAH has never been studied in detail so far. The aim of this study was to determine the prevalence and characteristics of long-term burdensome headache in good-grade SAH patients as well as its relation to health-related quality of life (HR-QOL).

Methods: All SAH cases treated between January 2014 and December 2016 with preserved consciousness at hospital discharge were prospectively interviewed regarding burdensome headache in 2018. Study participants were subsequently scrutinized by means of a standardized postal survey comprising validated pain and HR-QOL questionnaires. A retrospective chart review provided data on the initial treatment.

Results: A total of 93 out of 145 eligible SAH patients participated in the study (62 females). A total of 41% (38/93) of subjects indicated burdensome headache at follow-up (mean 32.6 ± 9.3 months). Comparison between patients with (HA+) and without long-term headache (HA-) revealed significantly younger mean age (47.9 ± 11.8 vs. 55.6 ± 10.3 years; p < .01) as well as more favorable neurological conditions (WFNS I/II: 95% vs. 75%; p = .03) in HA+ cases. The mean average headache of the HA+ group was 3.7 ± 2.3 (10-point numeric rating scale), and the mean maximum headache intensity was 5.7 ± 2.9. Pain and HR-QOL scores demonstrated profound alterations in HA+ compared to HA- patients.

Conclusions: Our results suggest that a considerable proportion of SAH patients suffers from burdensome headache even years after the hemorrhage. Moreover, long-term headache is associated with reduced HR-QOL in these cases.

Keywords: Headache; Intracranial aneurysm; Quality of life; Subarachnoid hemorrhage.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Flowchart 1
Flowchart 1
Study inclusion criteria and reasons for exclusion of potentially eligible cases
See this image and copyright information in PMC

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