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Published on: June 2, 2014
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.
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.
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.
