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Open Access 26-02-2024 | Headache | Original Communication

Don’t delay, but don’t despair: symptom duration, comorbidity and outcome after closure of spinal cerebrospinal fluid leaks

Authors: Florian Volz, Amir El Rahal, Christian Fung, Mukesch Shah, Niklas Lützen, Horst Urbach, Jürgen Beck, Katharina Wolf

Published in: Journal of Neurology | Issue 5/2024

Abstract

Objective

Microsurgical sealing of spinal cerebrospinal fluid (CSF) leaks is a viable treatment option in spontaneous intracranial hypotension (SIH). Several factors may influence the outcome, with symptom duration probably the most modifiable variable.

Methods

Patients with closure of spinal CSF leaks between September 2020 and March 2023 and a follow-up period of 6 months were included in this retrospective single-center study. Pre- and postoperative scores for impact of headaches (Headache Impact Test, HIT-6) and quality of life (QoL, EQ-5D-5L) were systematically collected. Multiple regression modelling and subgroup analyses for different symptom durations and comorbidities were performed for these outcomes.

Results

One hundred patients (61% female, median age 43.5 years) were included. Six months postoperatively, there was significant improvement in headache impact (HIT-6: 66 (IQR 62–69) to 52 (IQR 40–61, p < 0.001) and QoL (EQ-5D-5L VAS: 40 (IQR 30–60) to 79 (IQR 60–90); EQ-5D-5L Index: 0.67 (IQR 0.35–0.8) to 0.91 (IQR 0.8–0.94, p < 0.001, respectively). Subgroup analysis for a symptom duration above (74%) and below 90 days (26%) and comorbidity, as well as multiple regression analysis, revealed a trend in favor of early treatment and lower comorbidity. However, even after a prolonged symptom duration, improvements were significant.

Conclusion

As patients with shorter symptom duration show a trend for a better outcome, our results promote a timely diagnosis and treatment in SIH patients. However, a significant postoperative improvement can still be expected even after a prolonged symptom duration.

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Title: Don’t delay, but don’t despair: symptom duration, comorbidity and outcome after closure of spinal cerebrospinal fluid leaks
Authors: Florian Volz
Amir El Rahal
Christian Fung
Mukesch Shah
Niklas Lützen
Horst Urbach
Jürgen Beck
Katharina Wolf
Publication date: 26-02-2024
Publisher: Springer Berlin Heidelberg
Keywords: Headache
Hypotension
Hypotension
Published in: Journal of Neurology / Issue 5/2024
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-024-12242-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Don’t delay, but don’t despair: symptom duration, comorbidity and outcome after closure of spinal cerebrospinal fluid leaks

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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