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Review
. 2024 Dec;28(12):1273-1287.
doi: 10.1007/s11916-023-01181-8. Epub 2023 Oct 24.

Headache Management in the Neuroscience Intensive Care Unit

Daniela Pomar-Forero  1 , Bakhtawar Ahmad  1 , Brooke Barlow  2 , Katharina M Busl  1   3 , Carolina B Maciel  4   5   6   7
Affiliations
Review

Headache Management in the Neuroscience Intensive Care Unit

Daniela Pomar-Forero et al. Curr Pain Headache Rep. 2024 Dec.

Abstract

Purpose of review: Headache is a common symptom in the Neuroscience Intensive Care Unit (NeuroICU). Our goal is to provide an overview of approaches to headache management for common neurocritical care conditions.

Recent findings: Headache disorders afflict nearly half of patients admitted to the NICU. Commonly encountered disorders featuring headache include cerebrovascular disease, trauma, and intracranial infection. Approaches to pain are highly variable, and multimodal pain regimens are commonly employed. The overall body of evidence supporting therapeutic strategies to manage headache in the critical care setting is slim, and pain control remains suboptimal in many cases with persistent reliance on opioids. Headache is a complex, frequently occurring phenomenon in the NeuroICU care setting. At present, literature on evidence-based practice for management of headache in the critical care setting remains scarce, and despite multimodal approaches, reliance on opioids is commonplace.

Keywords: Headache; Multimodal analgesia; Neurocritical care; Opioids; Subarachnoid hemorrhage.

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Conflict of interest statement

Compliance with Ethical Standards. Disclosure: Daniela Pomar-Forero reports no relevant disclosures. Bakhtawar Ahmad reports no relevant disclosures. Brooke Barlow reports no relevant disclosures. Katharina M. Busl and Carolina B. Maciel are co-principal investigators on BLOCK-SAH study, which is a multicenter, randomized trial investigating the role of pterygopalatine fossa nerve block as a potential treatment in post-SAH headaches. Conflict of Interest: The authors declare no conflict of interest. Human and Animal Rights and Informed Consent: This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of special importance •• Of outstanding importance
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