Rocha-Filho Pas, Gherpelli Jld, de Siqueira Jtt, Rabello Gd
Department of Neurology, Clinics Hospital of the University of São Paulo, São Paulo, SP, Brazil.
Cephalalgia. 2010 Feb 22. doi: 10.1111/j.1468-2982.2009.2010.x.
Seventy-nine patients with intracranial aneurysms were evaluated in the presurgical period, and followed up to 6 months after surgery. We compare patients who fulfilled with those that did not post-craniotomy headache (PCH) diagnostic criteria, according to the International Classification of Headache Disorders. Semistructured interviews, headache diaries, Short Form-36 and McGill Pain Questionnaire were used. Seventy-two patients (91%) had headaches during the follow-up period. The incidence of PCH according to the International Headache Society diagnostic criteria was 40%. Age, sex, type of surgery, temporomandibular disorder, vasospasm, presence and type of previous headaches, and subarachnoid haemorrhage were not related to headache classification. There were no differences in the quality of life, headache frequency and characteristics or pain intensity between patients with headache that fulfilled or not PCH criteria. We proposed a revision of the diagnostic criteria for PCH, extending the headache outset after surgery from 7 to 30 days, and including the presence of headaches after surgery in patients with no past history of headaches, or an increase in headache frequency during the first 30 days of the postsurgical period followed by a decrease over time. Using these criteria we would classify 65% of our patients as having PCH.
对79例颅内动脉瘤患者进行了术前评估，并在术后随访6个月。根据《头痛疾病国际分类》，我们比较了符合和不符合开颅术后头痛（PCH）诊断标准的患者。采用了半结构化访谈、头痛日记、简短健康调查问卷（Short Form-36）和麦吉尔疼痛问卷。72例患者（91%）在随访期间出现头痛。根据国际头痛协会诊断标准，PCH的发生率为40%。年龄、性别、手术类型、颞下颌关节紊乱、血管痉挛、既往头痛的存在及类型以及蛛网膜下腔出血与头痛分类无关。符合或不符合PCH标准的头痛患者在生活质量、头痛频率和特征或疼痛强度方面没有差异。我们建议修订PCH的诊断标准，将术后头痛开始时间从7天延长至30天，并包括既往无头痛病史的患者术后出现头痛，或术后前30天内头痛频率增加，随后随时间下降的情况。使用这些标准，我们将65%的患者归类为患有PCH。
