Correction of postoperative cranialgia in neurosurgical patients

Abstract

Introduction.According to various data, postcraniotomy headache (PCH) is observed in 60-80% of cases, but so far this problem has not been given due attention. Non-modifiable risk factors affecting the intensity of PCG are female sex, young age, anxiety and depressive disorders; the main modifiable factor is craniotomy access.The aim of this studyis to improve the outcomes of neurosurgical interventions by reducing the severity of postoperative cephalalgia.Materials and methods.A comparative analysis of the severity of postcraniotomy headache in the early and immediate postoperative period was carried out in 2 groups of patients: with classical osteoplastic craniotomy (control group) and using a low-trauma technique for removing intracerebral hematoma (main group). To assess the level of cranial pain, a digital pain rating scale was used.Results.The average indicators of the intensity of cephalalgia in the early period in the control group was 7.5 ± 1.5, in the main group 6.1 ± 1.2, in the nearest: the control group 5.6 ± 1.4, the main one – 3.9 ± 1.1 (p<0.05).Discussion.The reduction in the volume of the surgical wound significantly led to a decrease in the intensity of the postoperative cephalgic syndrome. A number of techniques have been proposed in the literature as surgical and medical methods for the prevention of postcraniotomy headache, but they do not have an adequate evidence base and require further study. A decrease in the intensity of PCG helps to improve the quality of life of patients and to reduce the financial costs required for its treatment.Conclusions.The use of a minimally traumatic technique of intracerebral hematoma removal contributes to the reduction of postoperative cephalgia in patients in the immediate postoperative period.