Purpose: The purpose was to examine headache pain experienced by women following EFS, an extracranial surgical dissection involving the trigeminal nerve.
Specifically, this study described: 1) intensity, location, quality, and duration of headache pain; 2) compare headache experience following EFS with migraine; 3)
examine medication use and perceived relief; 4) to evaluate the relationship between headache pain and a) emotional status and b) functional status; and 5) to
evaluate the effect of estrogen levels on headache for women following endoscopic foreheadplasty surgery (EFS).
Most women experienced bilateral headache (97%), with the majority reporting severe to moderate pain (71%), which was not consistently relieved with prescriptive
strategies. Most women 78% (N=33) experience pain with symptoms meeting International Headache Society Criteria for migraine or probable migraine for. Physical
health scores were significantly below normal on postoperative days (POD) 1, 3 and 7 (p<0.05), and had recovered on POD 30. Mental health scores were below
normal on postoperative days 1 and 3, returning to baseline by POD seven. These study findings present for the first time evidence that migraine can occur from
Women experience pain following EFS, which is usually similar to migraine. This similarity suggests that, for some patients, migraine preventives may benefit
management of postoperative headache pain. With regards migraines outside of the context of EFS, these findings raise the possibility that some episodes are initiated
by extracranial events activating the trigeminovascular system. This study also offers more evidence that HRTs and with a history of migraine both influenced headache
episodes and characteristics. It would be of interest to explore if HRTs and history of migraine has influence on other medical conditions and surgical procedures with
and without pain. The findings of major influences of HRT and migraine family history on pain experience suggest these factors may predict varying pain responses to
other medical conditions or procedures. In summary, management of EFS patients postoperatively should address pain which may last for up to a month, and which
may not be well controlled with standard medications.
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