Preoperative headache in patients submitted to unrupted brain aneurysm clamping

ABSTRACT BACKGROUND AND OBJECTIVES: Headache is a major symptom referred by patients with brain aneurysm. As other types of pain, it is often ignored by the multiprofessional team. Although important, headache evaluation in the preoperative period of brain aneurysm clamping is a challenge for the health team. This study aimed at evaluating preoperative headache of patients submitted to unrupted aneurysm clamping. METHODS: This is a descriptive, exploratory and quantitative study carried out between September 2014 and May 2015 in the neurosurgery sector and the intensive care unit of a medium-sized hospital. Sample was made up of 28 patients in the preoperative period of elective craniotomy to treat unrupted brain aneurysm. Mann-Whitney, Kruskal-Wallis and Fisher Exact tests were used with significance level of 5%. RESULTS: It was observed that 78.6% of patients were females with mean age of 46.7 years. Moderate pulsing and frontal headache was the most prevalent pain. Nausea and vomiting were also present, as well as pain in the eye. Pain has worsened with physical effort and shaking the head. There has been statistically significant difference for the variables pain recurrence and pain in the eye. CONCLUSION: This article clarifies major items to be investigated to evaluate headache of brain aneurysm patients and its characteristics to help early diagnosis and better neurologic recovery.

摘要 背景与研究目的：头痛是脑动脉瘤（brain aneurysm）患者的主要主诉症状。与其他类型疼痛类似，此类头痛常被多专业协作团队忽视。尽管术前头痛评估至关重要，但针对拟接受脑动脉瘤夹闭术（aneurysm clamping）患者的术前头痛评估，对医护团队而言仍是一项挑战。本研究旨在评估接受未破裂脑动脉瘤夹闭术患者的术前头痛情况。
研究方法：本研究为描述性、探索性定量研究，于2014年9月至2015年5月期间在某中型医院的神经外科病区及重症监护室开展。研究样本纳入28例拟接受择期开颅术治疗未破裂脑动脉瘤的术前患者。研究采用曼-惠特尼U检验、克鲁斯卡尔-沃利斯H检验及费希尔精确检验，检验水准设定为5%。
研究结果：结果显示，78.6%的研究对象为女性，平均年龄为46.7岁。中度搏动性前额头痛为最常见的头痛类型。同时还可伴随恶心、呕吐及眼部疼痛。头痛可因体力活动及摇头而加重。头痛复发情况及眼部疼痛这两项变量存在统计学差异。
研究结论：本研究明确了脑动脉瘤患者头痛评估需重点关注的条目及其特征，可为早期诊断及更优良的神经功能康复提供参考。