Long-term headache after spontaneous intracerebral haemorrhage.

BACKGROUND: Though headache is commonly observed after stroke and may affect survivors' quality of life, it has rarely been studied after spontaneous intracerebral haemorrhage (ICH). In a cohort of ICH survivors, we assessed the long-term prevalence and determinants of headache. METHODS: We screened consecutive ICH survivors enrolled in the prospective, single-centre Prognosis of Intracerebral Haemorrhage study for headache 1, 3, and 6 years after ICH, according to the International Headache Society's criteria. Depressive and anxiety symptoms severity was measured at 1-year follow-up. Variables associated with the presence of headache 1 year after ICH were analyzed using univariate and multivariable models. RESULTS: Among the 146 patients included in this study, 31 (21%), 25 (19%), and 14 (20%) patients reported headache at 1-, 3-, and 6-year follow-up, respectively. In an age-adjusted model, patients with headache at ICH onset (adjusted odds ratio [aOR] 2.75; 95% CI 1.02-7.42) and previous history of headache (aOR 4.60; 95% CI 1.74-12.1) were associated with headache at 1-year follow-up. Patients with headache were more likely to report depressive and anxiety symptoms at 1-year follow-up (both p < 0.02). CONCLUSIONS: One in five ICH survivors suffered from headache and patients who reported headache at ICH onset were especially at risk.

Blunt dissection technique with finger and vessel skeletonization in the posterior vesical wall for abnormally invasive placenta previa.

Purpose: This study described a new technique to minimize the bleeding resulted from aberrant engorged vessels and unintended bladder injury in cases with abnormally invaded placenta adjacent to posterior bladder wall at cesarean hysterectomy.Methods: After filling the bladder with 300 ml saline aberrant engorged vessels were identified and skeletonized between lower uterine segment and bladder with blunt dissection by index finger down to the distal end point of cervix.Results: This technique has beneficial effect on preventing bladder injury and reduces bleeding resulting from the aberrant vessels and the communicating vessels that were based around the vesicouterine fold and the cervico-vesical interface (in the lower part of the cervix); respectively.Conclusion: Our procedure may have some benefits including shorter operation time, lower amount of hemorrhage, and less bladder injury where anatomical landmarks are unclear, especially in abnormally invasive placentation adjacent to posterior bladder wall at cesarean hysterectomy.