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Postcraniotomy headache

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Abstract

Although pain after craniotomy is a clinically significant problem that has a continuously expanding literature, it is still a source of concern and controversy. Postcraniotomy headache (PCH) has been neglected for years. It is assessed regularly by only a few neurosurgical centers, and its frequency and severity tend to be underestimated by medical staff; hence, PCH is often undertreated and poorly managed. Various patient and surgical factors have an impact on the severity and incidence of PCH; thus, effective analgesic protocols are hard to define, which could explain the absence of available therapeutic guidelines. According to recent studies, certain surgical measures and the use of local anesthetics are promising in the prevention of PCH. NSAIDs seem to have inadequate analgesic effects, whereas opioids have a wide range of drawbacks; nevertheless, both types of medicaments are regarded as cornerstones of a balanced and adequate multimodal therapy. The purpose of this review is to collect the currently available knowledge about the incidence, assessment, pathophysiological mechanism, and predictors of acute and chronic PCH. Therefore, a broad search of the literature has been carried out to collect evidence of potential prevention and treatment strategies.

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Acknowledgments

This work was not funded and had no financial support or sponsorship. None of the authors has any conflict of interest. The work of LM and RN was supported by the Junior Research fellow grant of the European Union and the Hungarian Government (National Excellency Programme), registration number: TÁMOP 4.2.4.A/2-11-1-2012-0001.

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Authors and Affiliations

  1. Department of Anesthesiology and Intensive Care, University of Debrecen Medical and Health Science Center, Nagyerdei krt. 98, Debrecen, 4032, Hungary

    Levente Molnár, Éva Simon, Réka Nemes, Béla Fülesdi & Csilla Molnár

  2. Outcomes Research Consortium, Eastern European Center, Debrecen, Hungary

    Béla Fülesdi

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  1. Levente Molnár
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  2. Éva Simon
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  3. Réka Nemes
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  4. Béla Fülesdi
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  5. Csilla Molnár
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Correspondence to Csilla Molnár.

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Molnár, L., Simon, É., Nemes, R. et al. Postcraniotomy headache. J Anesth 28, 102–111 (2014). https://doi.org/10.1007/s00540-013-1671-z

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  • DOI: https://doi.org/10.1007/s00540-013-1671-z

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