5.6 Persistent headache attributed to craniotomy

Description:
Headache of greater than three months’ duration caused by surgical craniotomy.

Diagnostic criteria:
A. Any headache fulfilling criteria C and D
B. Surgical craniotomy1 has been performed
C. Headache is reported to have developed within 7 days after one of the following:

    1. the craniotomy
    2. regaining of consciousness following the craniotomy
    3. discontinuation of medication(s) that impair ability to sense or report headache following the craniotomy

D. Headache persists for >3 months after the craniotomy
E. Not better accounted for by another ICHD-3 diagnosis.

Note:
1. When the craniotomy was performed following head injury, code as 5.2.1 Persistent headache attributed to moderate or severe traumatic injury to the head.

Comments:
About a quarter of patients who develop 5.5 Acute headache attributed to craniotomy go on to experience 5.6 Persistent headache attributed to craniotomy.

When headache following craniotomy becomes persistent, the possibility of 8.2 Medication-overuse headache needs to be considered.