Yu-Hsiang Ling1,2, Yen-Feng Wang1,2, Jiing-Feng Lirng2,3, Jong-Ling Fuh1,2,4, Shuu-Jiun Wang1,2,4, Shih-Pin Chen5,6,7,8,9. 1. Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan. 2. School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. 3. Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan. 4. Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. 5. Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan. chensp1977@gmail.com. 6. School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. chensp1977@gmail.com. 7. Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. chensp1977@gmail.com. 8. Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan. chensp1977@gmail.com. 9. Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. chensp1977@gmail.com.
Abstract
BACKGROUND: Chronic headache may persist after the remission of reversible cerebral vasoconstriction syndrome (RCVS) in some patients. We aimed to investigate the prevalence, characteristics, risk factors, and the impact of post-RCVS headache. METHODS: We prospectively recruited patients with RCVS and collected their baseline demographics, including psychological distress measured by Hospital Anxiety and Depression scale. We evaluated whether the patients developed post-RCVS headache 3 months after RCVS onset. The manifestations of post-RCVS headache and headache-related disability measured by Migraine Disability Assessment (MIDAS) scores were recorded. RESULTS: From 2017 to 2019, 134 patients with RCVS were recruited, of whom, 123 finished follow-up interviews (response rate 91.8%). Sixty (48.8%) patients had post-RCVS headache. Migrainous features were common in post-RCVS headache. Post-RCVS headache caused moderate-to-severe headache-related disability (MIDAS score > 10) in seven (11.7%) patients. Higher anxiety level (odds ratio 1.21, p = 0.009) and a history of migraine (odds ratio 2.59, p = 0.049) are associated with post-RCVS headache. Survival analysis estimated that 50% post-RCVS headache would recover in 389 days (95% confidence interval: 198.5-579) after disease onset. CONCLUSIONS: Post-RCVS headache is common, affecting half of patients and being disabling in one-tenth. Higher anxiety level and migraine history are risk factors. Half of the patients with post-RCVS headache would recover in about a year.
BACKGROUND: Chronic headache may persist after the remission of reversible cerebral vasoconstriction syndrome (RCVS) in some patients. We aimed to investigate the prevalence, characteristics, risk factors, and the impact of post-RCVS headache. METHODS: We prospectively recruited patients with RCVS and collected their baseline demographics, including psychological distress measured by Hospital Anxiety and Depression scale. We evaluated whether the patients developed post-RCVS headache 3 months after RCVS onset. The manifestations of post-RCVS headache and headache-related disability measured by Migraine Disability Assessment (MIDAS) scores were recorded. RESULTS: From 2017 to 2019, 134 patients with RCVS were recruited, of whom, 123 finished follow-up interviews (response rate 91.8%). Sixty (48.8%) patients had post-RCVS headache. Migrainous features were common in post-RCVS headache. Post-RCVS headache caused moderate-to-severe headache-related disability (MIDAS score > 10) in seven (11.7%) patients. Higher anxiety level (odds ratio 1.21, p = 0.009) and a history of migraine (odds ratio 2.59, p = 0.049) are associated with post-RCVS headache. Survival analysis estimated that 50% post-RCVS headache would recover in 389 days (95% confidence interval: 198.5-579) after disease onset. CONCLUSIONS: Post-RCVS headache is common, affecting half of patients and being disabling in one-tenth. Higher anxiety level and migraine history are risk factors. Half of the patients with post-RCVS headache would recover in about a year.
Authors: Seby John; Aneesh B Singhal; Leonard Calabrese; Ken Uchino; Tariq Hammad; Stewart Tepper; Mark Stillman; Brittany Mills; Tijy Thankachan; Rula A Hajj-Ali Journal: Cephalalgia Date: 2015-06-18 Impact factor: 6.292