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Medication overuse as a cause of chronic headache in shunted hydrocephalus patients.
Willer, L; Jensen, R H; Juhler, M.
Affiliation
  • Willer L; Danish Headache Centre, Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark.
J Neurol Neurosurg Psychiatry ; 81(11): 1261-4, 2010 Nov.
Article in En | MEDLINE | ID: mdl-20660917
ABSTRACT

PURPOSE:

To highlight the group of hydrocephalus patients known to have a long history of shunt revisions and refractory chronic headache. When a shunt in perfect working order has no effect on headache, other causes of headache should be investigated. In this paper, patients with medication overuse headache are identified and the positive effect of medication withdrawal are described. MATERIALS AND

METHOD:

Patients with hydrocephalus and shunt referred from the neurosurgical department to the Danish Headache Centre were identified. In all cases, over- and underdrainage was ruled out prior to referral. Six patients with medication overuse headache were documented and their charts were reviewed retrospectively with specific attention to shunt revisions, inpatient and outpatient contacts, headache data and medication use before and after withdrawal of analgesic medication overuse.

RESULTS:

A marked reduction in shunt revisions and inpatient contacts in five out of six patients was found and a reduction in outpatient contacts in four out of six patients. Furthermore, an improvement in headache intensity was found in three out of six patients and a reduction in duration was found in two out of six patients.

CONCLUSION:

This study indicates that it is important to identify shunt patients with persistent chronic headache from causes other than shunt malfunction. By reducing their analgesic intake, it is possible to reduce headaches, the number of surgical interventions and hospital contacts. Hopefully this will raise awareness and lead to further research on the subject.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Cerebrospinal Fluid Shunts / Headache Disorders, Secondary / Hydrocephalus / Analgesics Type of study: Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: J Neurol Neurosurg Psychiatry Year: 2010 Document type: Article Affiliation country:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Cerebrospinal Fluid Shunts / Headache Disorders, Secondary / Hydrocephalus / Analgesics Type of study: Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: J Neurol Neurosurg Psychiatry Year: 2010 Document type: Article Affiliation country: