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Post craniotomy headache in patients with benign lesions of the brain - a single center observational study
EANS Academy. Hackl M. Sep 27, 2019; 276152; EP11012
Marina Hackl
Marina Hackl

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Abstract
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Background: Post craniotomy headache persisting four months or more after surgery of the brain in Patients with benign lesions can significantly reduce their quality of life. Studies that evaluate risk factors prior to surgery for post craniotomy headache have shown conflicting results. The aim of our observational study was to evaluate the change as well as the development of headache in patients with benign intracranial diagnoses.
Methods: Our study evaluated patients of 18 years and older who underwent elective craniotomy for the first time. We evaluated the patients' headache shortly prior and 4 to 12 months after the procedure to determine whether there was a change or a new occurrence of chronical headache. Clinical data, intraoperative data and data on headache characteristics according to the IHS classification have been recorded. Moreover we evaluated depressive symptoms.
Results: Of 112 patients who underwent craniotomy, we analyzed datasets from 89 patients so far with completed follow up after 4 to 12 months. The mean age was 52,63 years, 65,2% of the patients were female. 52,8 % were treated because of benign tumors (WHO I), 15,7% because of intracranial aneurysms, 10,1% for cavernoma, 5,6% for microvascular decompression (Jannetta) and 15,7 % for other reasons. 28,1 % of the operated patients reported new headache or a change in the quality of former headaches with a higher proportion of post craniotomy headache in surgery for intracranial aneurysms and cavernomas. 32,6% reported an improvement or a disappearance of headache and 39,3% did not notice any changes.
Conclusion: This study describes the occurrence and the phenotype of chronical headache after elective cranial surgery. We found a rate of approximately 30% of post craniotomy headache. In further analysis we aim to investigate the influence of operative procedures and neuroimaging findings on the development of post craniotomy headache.
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