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Acta Neurochirurgica
Published in: Acta Neurochirurgica 4/2020

Open Access 01-04-2020 | Intracranial Aneurysm | Original Article - Vascular Neurosurgery - Aneurysm

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

Authors: Torge Huckhagel, Regine Klinger, Nils Ole Schmidt, Jan Regelsberger, Manfred Westphal, Patrick Czorlich

Published in: Acta Neurochirurgica | Issue 4/2020

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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.
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Metadata
Title
The burden of headache following aneurysmal subarachnoid hemorrhage: a prospective single-center cross-sectional analysis
Authors
Torge Huckhagel
Regine Klinger
Nils Ole Schmidt
Jan Regelsberger
Manfred Westphal
Patrick Czorlich
Publication date
01-04-2020
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 4/2020
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-020-04235-7

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