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

AbstractBackgroundAneurysmal 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).MethodsAll 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.ResultsA 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 
Source: Acta Neurochirurgica - Category: Neurosurgery Source Type: research

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A 48-year-old woman spontaneously developed occipital pain, without any other neurological deficit. A brain magnetic resonance angiography showed narrowing, irregular dilatation, and aneurysmal formation in both the vertebral arteries (VA). According to these findings and the clinical course, we diagnosed the patient with spontaneous VA dissection. There was no finding suggesting cerebral infarction or subarachnoid hemorrhage. Three-dimensional T1-weighted magnetic resonance imaging performed 27days after first onset of headache revealed a crescent-shaped high-intensity lesion in both the VA walls.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Tags: Case Reports Source Type: research
AbstractPurpose of ReviewHere, we describe the four primary imaging modalities for identification of carotid artery dissection, advantages, limitations, and clinical considerations. In addition, imaging characteristics of carotid dissection associated with each modality will be described.Recent FindingsRecent advances in etiopathogenesis describe the genetic factors implicated in cervical artery dissection. MRI/MRA (magnetic resonance angiography) with fat suppression is regarded as the best initial screening test to detect dissection. Advances in magnetic resonance imaging for the diagnosis of dissection include the use o...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
A 28-year-old healthy man was admitted to our hospital because of right-sided headache, vomiting, and lower back pain after the administration of vardenafil. Computed tomography and magnetic resonance imaging of the brain showed a small, right-sided, subdural hematoma. A lumbar magnetic resonance imaging showed a longitudinally extended subdural hematoma. He had no history of trauma. We speculated that vardenafil might have had an association with the bleeding. Several reports have suggested a relationship between phosphodiesterase-5 inhibitors and intracerebral or subarachnoid hemorrhage.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Tags: Case Studies Source Type: research
This study describes characteristics of FMD patients with and without A and/or D (A/D).Methods: Patients enrolled in the US Registry for FMD between 2009-2017 and had A/D information were analyzed (n=985). Diagnosis of A/D was ascertained from patient charts or self-reported via medical history questionnaires at time of registry enrollment. Demographics, family history, past medical history, presenting symptoms, and affected vascular beds were compared between patients with and without A/D.Results: A total of 351 (35.6%) had A/D. Of patients with A/D, 126 (35.9%) had both. Patients with A/D were more likely to have a famil...
Source: Circulation: Cardiovascular Quality and Outcomes - Category: Cardiology Authors: Tags: Session Title: Poster Session AM Source Type: research
AbstractThis systematic review summarizes the existing data on headache and pregnancy with a scope on clinical headache phenotypes, treatment of headaches in pregnancy and effects of headache medications on the child during pregnancy and breastfeeding, headache related complications, and diagnostics of headache in pregnancy. Headache during pregnancy can be both primary and secondary, and in the last case can be a symptom of a life-threatening condition. The most common secondary headaches are stroke, cerebral venous thrombosis, subarachnoid hemorrhage, pituitary tumor, choriocarcinoma, eclampsia, preeclampsia, idiopathic ...
Source: The Journal of Headache and Pain - Category: Neurology Source Type: research
CONCLUSIONS: most common presenting complaint in patients was breathlessness seen in 17 patients (34%), followed by neurological deficit in 14 patients (28%). Thirteen patients (26%) had complaints of headache, whereas 12 (24%) patients complained of chest pain on admission. Other symptoms included vomiting, giddiness, psychomotor agitation, and decreased urine output. Out of a total of 4076 admissions during the study period in the intensive care unit we had 50 cases of hypertensive emergencies with prevalence of 1.22% in our intensive care unit. Most common organ involvement was the retina followed by cardiovascular syst...
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
Reversible cerebral vasoconstriction syndrome (RCVS), characterized by multifocal constrictions of cerebral arteries resolving spontaneously within 3 months, most commonly presents with unusual, severe, mostly thunderclap headaches (severe pain peaking in less than 1 minute).1,2 Seizures and focal neurologic deficits related to cortical subarachnoid hemorrhage, intracerebral hemorrhage, ischemic stroke, or posterior reversible encephalopathy syndrome may occur.3–5 Treatment relies on rest; withdrawal of any vasoactive drugs; avoidance of triggering factors; administration of nimodipine, given by analogy to aneurysmal...
Source: Neurology - Category: Neurology Authors: Tags: All Headache, Stroke in young adults, All Imaging, Vasculitis, All Cerebrovascular disease/Stroke EDITORIALS Source Type: research
Abstract PURPOSE OF REVIEW: Spreading depression (SD) is a wave of simultaneous and near-complete depolarization of virtually all cells in brain tissue associated with a transient "depression" of all spontaneous or evoked electrical activity in the brain. SD is widely accepted as the pathophysiological event underlying migraine aura and may play a role in headache pathogenesis in secondary headache disorders such as ischemic stroke, subarachnoid or intracerebral hemorrhage, traumatic brain injury, and epilepsy. Here, we provide an overview of the pathogenic mechanisms and propose plausible hypotheses on ...
Source: Epilepsy Curr - Category: Neurology Authors: Tags: Curr Pain Headache Rep Source Type: research
Abstract Purpose of Review Spreading depression (SD) is a wave of simultaneous and near-complete depolarization of virtually all cells in brain tissue associated with a transient “depression” of all spontaneous or evoked electrical activity in the brain. SD is widely accepted as the pathophysiological event underlying migraine aura and may play a role in headache pathogenesis in secondary headache disorders such as ischemic stroke, subarachnoid or intracerebral hemorrhage, traumatic brain injury, and epilepsy. Here, we provide an overview of the pathogenic mechanisms and propose...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
A 23-year-old healthy woman presented to the emergency department with a week-long history of intense, pulsatile, right-sided headache, accompanied by fever, diplopia, and right eye pain and decreased visual acuity. She reported partial relief with nonsteroidal anti-inflammatory drugs.
Source: Neurology - Category: Neurology Authors: Tags: All Infections, Bacterial infections, All Cerebrovascular disease/Stroke, Subarachnoid hemorrhage RESIDENT AND FELLOW SECTION Source Type: research
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