gms | German Medical Science

70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

Chronic headache following aneurysmal subarachnoid haemorrhage – a prospective cross-sectional study

Chronischer Kopfschmerz nach aneurysmatischer Subarachnoidalblutung – eine prospektive Querschnittstudie

Meeting Abstract

  • presenting/speaker Torge Huckhagel - Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
  • Manfred Westphal - Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
  • Jan Regelsberger - Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
  • Patrick Czorlich - Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV100

doi: 10.3205/19dgnc115, urn:nbn:de:0183-19dgnc1154

Published: May 8, 2019

© 2019 Huckhagel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Objective: Aneurysmal subarachnoid hemorrhage (SAH) constitutes a large part of stroke-related loss of lifetime and disability due to the severity of the condition and the relatively young age of the affected patients. The frequency of chronic headache in the long-term run in SAH patients is not well described. Aim of this study was to determine the prevalence and impact of chronic headache after SAH.

Methods: All SAH cases between 1/2014 and 12/2016 reaching a Glasgow Outcome Score ≥3 at hospital discharge were sent a standardized questionnaire in 2018. The survey comprised the 10-point numeric pain rating scale (NRS), the German version of the Headache Disability Inventory (HDI) and the 12-item short form Health Survey (SF-12). Chronic headache was defined as recurrent or persistent headache lasting ≥6 months. In addition, clinical and radiographic data on the initial SAH treatment were analyzed.

Results: 93 out of 145 eligible patients participated in the study (31 male, 62 female). 41% (38/93) of SAH patients indicated chronic headache at follow-up. The SAH cohort with chronic headache (CH+) was of significantly younger average age compared to cases without chronic headache (CH-) (47.9±11.8 vs. 55.6±10.3 ys; p<0.01). CH+ patients presented more frequently with lower WFNS grading scores compared to CH- cases (WFNS score ≤3: 97% of CH+ vs. 77% of CH- cases; p=0.03). All other clinical and radiographic data as well as treatment characteristics showed no significant differences between both groups. Mean average headache of the CH+ collective was 3.7±2.3/10 NRS and mean maximum headache intensity was 5.7±2.9/10 NRS respectively. 47% of CH+ patients suffered from headache attacks without continuous background pain, whereas 53% presented with permanent headache with or without additional pain attacks. HDI scores were considerably higher in CH+ cases (emotional score 17.7±14.6; functional score 17.4±12.9) than in CH- patients (emotional score 0.4±1.3; functional score 0.9±3.0; p<0.01). Physical health-related quality of life assessed by the physical composite score of the SF-12 was significantly reduced in CH+ compared to CH- cases (40.3±9.9 vs. 49.6±8.6; p<0.01), whereas both groups showed similar SF-12 mental health summary measures (CH+ 44.0±11.8 vs. CH- 49.2±9.6; p=0.06).

Conclusion: Our results suggest that a considerable proportion of SAH patients suffers from chronic headache. Furthermore, chronic headache seems to be associated with reduced health-related quality of life in these cases.