Mayer-Suess L, Frank F, Töll T, Boehme C, Gizewski ER, Ratzinger G, Broessner G, Kiechl S, Knoflach M. Head/neck pain characteristics after spontaneous cervical artery dissection in the acute phase and on a long-run.
Cephalalgia 2022;
42:872-878. [PMID:
35302384 PMCID:
PMC9315176 DOI:
10.1177/03331024221079298]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective
Head/neck pain is one of the primary symptoms associated with spontaneous
cervical artery dissection. Still, data on pain quality, intensity, and
long-term dynamics are scarce.
Methods
Spontaneous cervical artery dissection subjects were included if mural
hematoma was visualised through T1 fat-saturated MRI at baseline. All
available medical records were evaluated and patients were invited to
standardised clinical follow-up visits at least 1 year after the index
event.
Results
In total, 279 subjects were included in the ReSect-study with head/neck pain
being the most frequent symptom of spontaneous cervical artery dissection
(220 of 273, 80.6%). Pain was of pulling nature in 107 of 218 (49.1%), and
extended to the neck area in 145 of 218 (66.5%). In those with prior
headache history, pain was novel in quality in 75.4% (42 of 55). Median
patient-reported pain intensity was 5 out of 10 with thunderclap-type
headache being uncommon (12 of 218, 5.5%). Prior to hospital admission,
head/neck pain rarely responded to self-medication (32 of 218, 14.7%).
Characteristics did not differ between subjects with and without cerebral
ischemia. Pain resolved completely in all subjects within a median of 13.5
days (IQR 12). Upon follow-up in 42 of 164 (25.6%) novel recurring headache
occurred, heterogeneous in quality, localisation and intensity.
Conclusion
We present an in-depth analysis of spontaneous cervical artery
dissection-related head/neck pain characteristics and its long-term
dynamics.
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