Abstract:

Objective This prospective study was designed to explore the etiology of headache occurred after aneurismal subarachnoid hemorrhage(aSAH) and evaluate the effects of the multi-modality analgesia with compound tablet of oxycodone and acetaminophen in treatment of this kind of headache. Methods All of the 107 patients had angiographic demonstration of the presence of intracranial aneurysm and SAH was diagnosed upon CT studies within 24 hours of onset. Assessment of headache was made on the numeric rating scales(NRS) on days 1, 2, 3, 5, 7, 10 and 14 after SAH. Patients suffered from moderate-severe headache were examined by cranial CT scan and transcranial doppler(TCD) to find the reason, and their diversities were analyzed. Patients without etiological findings were divided to compound tablet of oxycodone and acetaminophen in a regimen of 1 tablet tid or Rotundine tablet in a regimen of 2 tablets tid for 3 days. Results Of the 107 patients, 93(86.9%) patients with SAH suffered from moderate-severe headache; in 9.7%(9/93) of them the headache was caused by rebleeding of untreated aneurysm, CT scan found hydrocephalus in 16.1%(15/93) patients with headache, TCD found intracranial vasospasm in 12.9%(12/93) of patients, 61.3%(57/93) of patients had negative results. There was a significant difference(P<0.01) between the actively treated group and control group in analgesic effects. Conclusion Majority of aSAH patients suffered from moderate to severe headache Multi-modality analgesia with compound tablet of oxycodone and acetaminophen was effective in treatment of moderate to severe headache occurred after aSAH without any pathological changes.

Key words: aneurismal subarachnoid hemorrhage, multi-modality analgesia, etiology