ArticleActa neurologica Belgica2026
Prevalence and clinical characterization of headache in patients with cranial bone defects: a single-center retrospective study.
Article in Acta neurologica Belgica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND AND
objectivesHeadache is a poorly characterized symptom in patients with residual cranial bone defects. This study aimed to describe the prevalence and clinical features of headache-including intensity, quality, postural modulation, associated symptoms, and relief factors-in a cohort awaiting cranioplasty.
methodsA retrospective, cross-sectional study was conducted at a tertiary neurosurgical referral center (January 2016 - May 2026). Adults with residual cranial bone defects following craniotomy were evaluated at a specialized headache clinic. Headache was assessed using the Visual Analogue Scale (VAS), neuropathic features with the DN4 questionnaire, and relief factors were systematically recorded. Descriptive statistics and between-group comparisons (chi-squared, Fisher's exact, and independent-samples t-tests) were conducted.
resultsOf 182 patients (mean age 45.4 ± 13.0 years; 60.4% male), 112 (61.5%) reported headache. Mean VAS was 5.7 ± 2.2, and 84.0% had at least moderate intensity. Headache was predominantly localized to the defect site (85.7%), with pressure/heaviness (68.8%) and tightness (66.9%) as the leading pain qualities. Neuropathic features were present in 6.2%. Associated symptoms-including vertigo (42.0%), photophobia (24.1%), and phonophobia (23.2%)-occurred exclusively or more frequently in the headache group (all p < 0.01). Relief factors were identified in 67.0% of patients, most commonly dipyrone (50.0%) and recumbency (10.7%).
conclusionHeadache affects most patients with cranial bone defects, presenting as a moderate-to-severe, defect-site-predominant syndrome with pressure-mediated features and a rich neurological accompaniment. Systematic headache assessment and evidence-based analgesic protocols are warranted in this population pending cranioplasty.
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