WHAT CAUSES POST SURGICAL HEADACHES?

[v357139]

I have seen and heard alot about post surgical headaches.  What causes them?  Are they more common with a certain surgical approach?

[arizonajack]

I'm no doctor but I'm guessing that cutting a hole in one's skull and fishing around inside with sharp instruments could cause enough trauma to result in post surgical headaches.

[LakeErie]

There are many theories about headaches as a complication of surgery. One is that bone dust from drilling out the IAC collects in CP angle and remains after surgery. Another theory is that the surgery transects the occipital nerves, upper and lower, and can damage those nerves with resulting headaches. There is a doctor named Ducic at Georgetown who removes the occipital nerves from AN patients experiencing headaches with success. My surgeon uses a minimally invasive technique to avoid transecting the occipital nerves in the first place. I had no headaches ever following my retrosigmoid surgery in Oct 2011.

[Cthelight]

Hi, I had retrosigmoid surgery for my Acoustic Neuroma in September 2012. I had my first headache two days later. I have suffered with them since then. Does anyone know of a AN headache specialist in WAshington State? I have been seeing a Neurologist and have tried many medications. Neurotic helps some but I still have them every day. Any suggestions or advise?

[v357139]

SML in Massachusetts had bad headaches that ended up getting better.  She mentioned things like Lyrica, physical therapy, and craniosacral therapy.  Maybe reach out to her.  I have also read elsewhere that a multi disciplinary approach works.  There is an article on this site somewhere by a Dr Leonetti that describes some headache treatments.

[staypoz]

LakeErie is right, there are many theories about the causes.  I am not a doctor either, but I think they really don't know.  The research seems to indicate that people who have retrosigmoid are ore likely to experience headaches.  But lots of folks have that surgery and have no headaches.  What I think would be worth investigating is what might pre-dispose some patients to have headaches post-op beyond surgical technique and history of headaches. 

staypoz

[Jim Scott]

LakeErie is right, there are many theories about the causes.  I am not a doctor either, but I think they really don't know.  The research seems to indicate that people who have retrosigmoid are ore likely to experience headaches.  But lots of folks have that surgery and have no headaches.  What I think would be worth investigating is what might pre-dispose some patients to have headaches post-op beyond surgical technique and history of headaches.

Good point.

I did not have headaches prior to my AN diagnosis (and it was large - 4.5 cm).  Underwent Retrosigmoid Approach debulking surgery followed by FSR (26 sessions - total of 27 Gy) and, again, never experienced headaches.  This proves nothing concrete but it does lead me to agree with your analysis that some AN patients, for whatever reason, may be predisposed to developing headaches.  Finding the reason would be a real medical breakthrough and could benefit many.     

Jim

[v357139]

Since some do not get headaches, but others suffer from them, definitely an issue that should be studied.  I agree it would be a great breakthrough.

[nftwoed]

Hi;
   Not 100% sure, but I think the bone dust theory issue has been solved?

[Nannybee]

From the International Headache Society IHS: I came across this when investigating post-op symptoms for my upcoming craniotomy this fall to remove the largest meningioma. (Had SRS for my AN)
Comments:
Immediate post-operative headache may occur in up to 80% of patients after craniotomy but resolves in most patients within 7 days. Fewer than one-quarter develop persistent (>3 months) headache related to the surgical procedure. Posterior fossa procedures, especially suboccipital craniotomies performed for acoustic neuromas, are more likely to be associated with post-craniotomy headache.

The pathogenesis of chronic headache after craniotomy is unclear but may involve meningeal inflammation, nerve entrapment, adhesion of muscle to dura or other mechanisms. Modifications in the operative procedure, including the use of osteoplastic cranioplasty, may lead to a reduction in the incidence of post-craniotomy headache by preventing adhesion of muscle and fascia to the underlying dura.

[mesafinn]

My mother had retrosigmoid surgery for a meningioma in 1996 and has had a headache (nearly) every day since.  But 24 hours before a thunderstorm, her headache goes from a 4 or 5 (on a 10-point pain scale) to a 8 or 9.  The change in air pressure absolutely impacts her headaches...something she had never experienced prior to her surgery.

She visited the country of Cyprus three years ago, a country that has over 300 days of sunshine a year and little fluctuation in air pressure.  The reason I wrote "(nearly) every day since" above is because for the one week she was in Cyprus, she did not have a headache!  It's the only week since 1996 she's been headache free.

I told her if it was me that I would be living in Cyprus by now!  But there's a correlation for her between her headaches and the weather that started immediately post-surgery.

[v357139]

Sounds like lots of research still needs to be done in this area, especially for retrosigmoid where some do not get headaches, and others do.

[Captain Deb]

You can order CD's from the ANA symposium headache workshops from the ANA by clicking on the logo in the upper right hand corner.  Dr Leonetti's from the Chicago symposium is really good.  He describes it as a "Chinese Menu"  There are so many causes--you could have one from column A, one from column B, and 2 from column C.  Everyone is different.  Personally I think mine were from the awkward surgical position on someone who already had a neck and occipital nerve problem because I had occipital headaches even before my surgery.

Capt Deb

[v357139]

Sorry you have them.  Seems people who had them before are more likely to get them after?  But some people never had them before also?