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The Prevalence and Long-Term Outcomes of Headaches after Aneurysmal Subarachnoid Hemorrhage: A Systematic Review

Published online by Cambridge University Press:  03 March 2025

Youngkyung Jung Open the ORCID record for Youngkyung Jung [Opens in a new window] ,
Natália Vasconcellos de Oliveira Souza ,
Teruko Kishibe ,
Fatma Ger Akarsu ,
Edwin Wong ,
Eduardo Pimenta Ribeiro Pontes Almeida ,
Arthur Tung Open the ORCID record for Arthur Tung [Opens in a new window] ,
Mohamad Kesserwan ,
Katrina Hannah Ignacio Open the ORCID record for Katrina Hannah Ignacio [Opens in a new window]  and
Marie Charmaine Cootauco Sy Open the ORCID record for Marie Charmaine Cootauco Sy [Opens in a new window]
...Show all authors
Youngkyung Jung*
Affiliation:
Division of Neurosurgery, Department of Surgery, St. Michael’s Hospital-Unity Health Toronto, University of Toronto, Toronto, Canada
Natália Vasconcellos de Oliveira Souza
Affiliation:
Division of Neurosurgery, Department of Surgery, St. Michael’s Hospital-Unity Health Toronto, University of Toronto, Toronto, Canada
Teruko Kishibe
Affiliation:
Health Sciences Library, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
Fatma Ger Akarsu
Affiliation:
Division of Neurology, Department of Medicine, St. Michael’s Hospital-Unity Health Toronto, University of Toronto, Toronto, Canada
Edwin Wong
Affiliation:
Division of Neurology, Department of Medicine, St. Michael’s Hospital-Unity Health Toronto, University of Toronto, Toronto, Canada
Eduardo Pimenta Ribeiro Pontes Almeida
Affiliation:
Department of Medical Imaging, McMaster University, Hamilton, Ontario, Canada
Arthur Tung
Affiliation:
Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
Mohamad Kesserwan
Affiliation:
Division of Neurosurgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
Katrina Hannah Ignacio
Affiliation:
Calgary Stroke Program, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada
Marie Charmaine Cootauco Sy
Affiliation:
Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
Nico Dimal
Affiliation:
Division of Neurology, Department of Medicine, Toronto Western Hospital- University Health Network, University of Toronto, Toronto, Canada
Karl Narvacan
Affiliation:
Department of Medical Imaging, St. Michael’s Hospital-Unity Health Toronto, University of Toronto, Toronto, Canada
Jimmy Li
Affiliation:
Neurology Division, Centre hospitalier universitaire de Sherbrooke (CHUS), Sherbrooke, QC, Canada
Pamela Danielle T. Lanuza
Affiliation:
Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
Jack Shujie Li
Affiliation:
Division of Neurology, Department of Medicine, St. Michael’s Hospital-Unity Health Toronto, University of Toronto, Toronto, Canada
Abdelsimar Tan Omar
Affiliation:
Division of Neurosurgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
Vitor Mendes Pereira
Affiliation:
Division of Neurosurgery, Department of Surgery, St. Michael’s Hospital-Unity Health Toronto, University of Toronto, Toronto, Canada Department of Medical Imaging, St. Michael’s Hospital-Unity Health Toronto, University of Toronto, Toronto, Canada Division of Diagnostic and Therapeutic Neuroradiology, St Michael’s Hospital-Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada
Julian Spears
Affiliation:
Division of Neurosurgery, Department of Surgery, St. Michael’s Hospital-Unity Health Toronto, University of Toronto, Toronto, Canada Department of Medical Imaging, St. Michael’s Hospital-Unity Health Toronto, University of Toronto, Toronto, Canada Division of Diagnostic and Therapeutic Neuroradiology, St Michael’s Hospital-Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada
Thomas R. Marotta
Affiliation:
Department of Medical Imaging, St. Michael’s Hospital-Unity Health Toronto, University of Toronto, Toronto, Canada Division of Diagnostic and Therapeutic Neuroradiology, St Michael’s Hospital-Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada
Atif Zafar
Affiliation:
Division of Neurology, Department of Medicine, St. Michael’s Hospital-Unity Health Toronto, University of Toronto, Toronto, Canada
Manav V. Vyas
Affiliation:
Division of Neurology, Department of Medicine, St. Michael’s Hospital-Unity Health Toronto, University of Toronto, Toronto, Canada Li Ka Shing Knowledge Institute, St. Michael’s Hospital-Unity Health Toronto, Toronto, Canada
Gustavo Saposnik
Affiliation:
Division of Neurology, Department of Medicine, St. Michael’s Hospital-Unity Health Toronto, University of Toronto, Toronto, Canada Li Ka Shing Knowledge Institute, St. Michael’s Hospital-Unity Health Toronto, Toronto, Canada
Jose Danilo Bengzon Diestro
Affiliation:
Division of Neurology, Department of Medicine, St. Michael’s Hospital-Unity Health Toronto, University of Toronto, Toronto, Canada Li Ka Shing Knowledge Institute, St. Michael’s Hospital-Unity Health Toronto, Toronto, Canada
*
Corresponding author: Youngkyung Jung; Email: jessica.jung@medportal.ca
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Abstract

Background:

Chronic headache after aneurysmal subarachnoid hemorrhage (aSAH) remains an ongoing area of investigation, with uncertainty regarding its prevalence and long-term outcomes.

Methods:

A systematic review was conducted across five databases – Medline (Ovid), the Cochrane Central Register of Controlled Trials (Ovid), PsychInfo (Ovid), Embase (Ovid) and Scopus (Elsevier) – to identify all studies investigating the prevalence of chronic headaches after aSAH. A total of five studies were identified and included in our review.

Results:

There were five observational studies (three cohort and two cross-sectional). The overall prevalence of chronic headaches after aSAH ranged from 16.1% to 41%, albeit across a follow-up time frame of 12 months to 7.5 years. Outcome measurements included quantitative pain scores and opioid usage; however, these were inconsistent across studies, and the studies did not address the long-term impacts of chronic headaches on quality of life or their psychosocial implications.

Conclusion:

The prevalence of chronic headache after aSAH is not well-characterized, and long-term outcomes are seldom studied, highlighting a critical gap in the current literature. Longitudinal cohort studies with standardized approaches to ascertain the psychosocial and physiological burden associated with post-aSAH chronic headaches are urgently needed.

Keywords

aneurysmal subarachnoidchronic headachequality of lifesubarachnoid hemorrhagesystematic review

Information

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 52 , Issue 6 , November 2025 , pp. 999 - 1005
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation

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