Robert S Eisinger1, Zachary A Sorrentino1, Brandon Lucke-Wold2, Sonya Zhou3, Brooke Barlow4, Brian Hoh2, Carolina B Maciel5,6, Katharina M Busl5. 1. University of Florida College of Medicine, Gainesville, Florida, USA. 2. Department of Neurosurgery, University of Florida College of Medicine, Gainesville, Florida, USA. 3. Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 4. Department of Pharmacy, University of Florida Shands Hospital, Gainesville, Florida, USA. 5. Department of Neurology, McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida USA. 6. Department of Neurology, University of Utah, Salt Lake City, Utah, USA.
Abstract
BACKGROUND: A clinical hallmark of aneurysmal SAH (aSAH) is headache. Little is known about post-aSAH headache factors which may point to underlying mechanisms. In this study, we aimed to characterize the severity and trajectory of headaches in relation to clinical features of patients with aSAH. METHODS: This is a retrospective longitudinal study of adult patients admitted to an academic tertiary care center between 2012 and 2019 with aSAH who could verbalize pain scores. Factors recorded included demographics, aneurysm characteristics, analgesia, daily morning serum sodium concentration, and occurrence of vasospasm. Group-based trajectory modeling was used to identify headache pain trajectories, and clinical factors were compared between trajectories. RESULTS: Of 91 patients included in the analysis, mean age was 57 years and 20 (22%) were male. Headache score trajectories clustered into two groups: patients with mild-moderate and moderate-severe pain. Patients in the moderate-severe pain group were younger (P<0.05), received more opioid analgesia (P<0.001), and had lower sodium concentrations (P<0.001) than patients in the mild-moderate pain group. CONCLUSION: We identified two distinct post-aSAH headache pain trajectory cohorts and identified an association with age, analgesia, and sodium levels. Future prospective studies considering sodium homeostasis and volume status under standardized analgesic regimens are warranted.
BACKGROUND: A clinical hallmark of aneurysmal SAH (aSAH) is headache. Little is known about post-aSAH headache factors which may point to underlying mechanisms. In this study, we aimed to characterize the severity and trajectory of headaches in relation to clinical features of patients with aSAH. METHODS: This is a retrospective longitudinal study of adult patients admitted to an academic tertiary care center between 2012 and 2019 with aSAH who could verbalize pain scores. Factors recorded included demographics, aneurysm characteristics, analgesia, daily morning serum sodium concentration, and occurrence of vasospasm. Group-based trajectory modeling was used to identify headache pain trajectories, and clinical factors were compared between trajectories. RESULTS: Of 91 patients included in the analysis, mean age was 57 years and 20 (22%) were male. Headache score trajectories clustered into two groups: patients with mild-moderate and moderate-severe pain. Patients in the moderate-severe pain group were younger (P<0.05), received more opioid analgesia (P<0.001), and had lower sodium concentrations (P<0.001) than patients in the mild-moderate pain group. CONCLUSION: We identified two distinct post-aSAH headache pain trajectory cohorts and identified an association with age, analgesia, and sodium levels. Future prospective studies considering sodium homeostasis and volume status under standardized analgesic regimens are warranted.
Authors: Paul A Harris; Robert Taylor; Robert Thielke; Jonathon Payne; Nathaniel Gonzalez; Jose G Conde Journal: J Biomed Inform Date: 2008-09-30 Impact factor: 6.317
Authors: G Hwang; E-A Jeong; J H Sohn; H Park; J S Bang; S-C Jin; B C Kim; C W Oh; O-K Kwon Journal: AJNR Am J Neuroradiol Date: 2012-04-05 Impact factor: 3.825
Authors: S M Dorhout Mees; D Bertens; H B van der Worp; G J E Rinkel; W M van den Bergh Journal: J Neurol Neurosurg Psychiatry Date: 2009-10-13 Impact factor: 10.154
Authors: Janice M Pogoda; Noah B Gross; Xianghong Arakaki; Alfred N Fonteh; Robert P Cowan; Michael G Harrington Journal: Headache Date: 2016-03-26 Impact factor: 5.887
Authors: Vishank A Shah; Syed Omar Kazmi; Rahul Damani; Alyssa Hartsell Harris; Samuel F Hohmann; Eusebia Calvillo; Jose I Suarez Journal: Front Neurol Date: 2022-06-16 Impact factor: 4.086