Chronic daily headache

Mark W Weatherall

doi:10.1136/jnnp.2007.124511

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Chronic daily headache

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unruptured intracranial aneurysms are potential candidates for chronic headache
oscar,m jolobe
Published on: 14 April 2016

Published on: 14 April 2016
unruptured intracranial aneurysms are potential candidates for chronic headache
- oscar,m jolobe, retired geriatriacian
Dear Editor,
Although chronic daily headache is considered by some neurologists to be one of the least engaging parts of their job(1), the author, nevertheless did remarkable justice to the topic in his review(1). Among the recent developments in the evaluation of chronic headache, ranging from headaches which occured daily to headaches occuring 2 to 3 times a month, was a retrospective analysis of symptom outcome...
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Dear Editor,
Although chronic daily headache is considered by some neurologists to be one of the least engaging parts of their job(1), the author, nevertheless did remarkable justice to the topic in his review(1). Among the recent developments in the evaluation of chronic headache, ranging from headaches which occured daily to headaches occuring 2 to 3 times a month, was a retrospective analysis of symptom outcome following interventional treatment of unruptured intracranial aneurysms in 49 patients who presented with preoperative chronic headache(including chronic daily headache)(2). All 49 had a history of chronic headache compliant with the definition used by the International Headache Society(3), and , in all 49 instances, comorbid neurological disorders(including giant aneurysms) which were potential causes of chronic headache had been excluded, as were comorbid diseases such as psychosis and hepatic encephalopathy(2). Among the 49 patients meeting the strict inclusion criteria 32 experienced marked improvement in headache(by 2 or more grades) following interventional treatment of intracranial aneurysms. As the authors themselves state, these observations do however require cautious interpretation in view of the retrospective nature of the study(giving rise to recall bias), and the possibility of a placebo effect(2). Furthermore, for the purposes of a review of chronic daily headache such as the one reported above(1), the authors did not specifically analyse the outcome in the subgroup of chronic headache patients in whom the headaches were of daily occurence(2).
Oscar M Jolobe
References
(1) Weatherall MY. Review: Chronic daily headache Practical Neurology 2007:7:212-21
(2)Kong D-S., Hong S-L., Jung Y-J., Kim JS. Improvement of chronic headache after treatment of unruptured intracranial aneurysms Headache 2007:47:693-7
(3)Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders, 2nd Ed. Cephalalgia 2004;24(suppl 1):9-160
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Conflict of Interest:
None declared.
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