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Elective Hospitalizations for Intractable Headache: Outcomes and Response Predictors.

Jessica Kiarashi1, Yasmin Jion1, Brandon Giglio1

  • 1UT Southwestern Medical Center (JK), Dallas; National Neuroscience Institute (YJ), Singapore; NYU Langone Medical Center (BG); Montefiore Medical Center (JP, CEA, RBL), Bronx, NY; Hartford Healthcare Headache Center (BMG), West Hartford, CT; Columbia University Medical Center (SV), Westchester; and Weill Cornell Medicine (MSR), New York, NY.

Neurology. Clinical Practice
|September 6, 2021
PubMed
Summary
This summary is machine-generated.

Inpatient headache treatment using various therapies showed high short-term improvement rates for chronic migraine and other headache disorders. Many patients maintained improvement after discharge, suggesting the value of hospitalized care.

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Area of Science:

  • Neurology
  • Clinical Medicine

Background:

  • Headache disorders represent a significant global health burden.
  • Intractable headache cases often require intensive management strategies.
  • Inpatient care offers a controlled environment for complex headache management.

Purpose of the Study:

  • To evaluate the outcomes of inpatient treatments for diverse headache disorders.
  • To identify factors predicting treatment response in hospitalized patients.
  • To assess both short-term and intermediate-term efficacy of various therapies.

Main Methods:

  • Retrospective chart review of elective inpatient headache admissions (2014-2018).
  • Analysis of diverse intravenous (IV) medications and nerve blocks administered.
  • Assessment of patient outcomes at discharge and post-hospitalization follow-up.

Main Results:

  • 90.4% of patients experienced pain improvement at discharge.
  • Significant reductions in headache intensity were observed (mean reduction of 4.84 points).
  • High improvement rates were noted with IV dihydroergotamine (89.4%) and nerve blocks (100%).
  • 84% of improved patients followed up, with 79.4% remaining improved at intermediate-term follow-up.

Conclusions:

  • Inpatient headache management utilizing heterogeneous therapies yields high short- and intermediate-term improvement rates.
  • Polytherapy and stratified hospitalized care may be beneficial for patients with intractable headache disorders.
  • Further research into predictors of long-term response is warranted.