post sub arachnoid clip operation, severe headache

[wdavis99]

my mother had emergency brain surgery 3 days ago to clip a leaking anuerysm. the surgery went well and she was out of icu in 2 dayswith no complications.  Into the 4th day she has no neurological stroke related complications and is able to walk around and speak normally.  There is no sign of vasospasm and the doctors here believe she will be discharged as early as one week from operation date(10/18/07).  However.... she complains of severe pain in her head behind her eye on the side of the craniotomy and an overall severe headache which is described constantly as "THE WORST HEADACHE OF HER LIFE" she complains constantly and on the third day was given a shot of panadeine. This shot really made her drunk and seemed similar to a heroin mainline. she quietly mentioned that the shot got rid of the headache completely but in 2 hours started complaining that the headache was back worse than before.  that night she got another shot of the same drug and went to sleep only to wake up begging for more and complaining of excruciating head pain.  after this I ordered all narcotics to be stopped except for small doses of codeine.  I feel like the strong IV narcotics are so addictive and only stop the headache for 2 hours so they are not worth it.
my question is: what is the medical significance of the post craniotomy headache and its relation to her surgery,  how long might she have this pain, and how should we handle this particularly in reference to the managemant of this pain, since after all it seems to be the only negative side affect of the life saving surgery.
thanks, a concerned son.

[Abhijeet Deshmukh, MD]

Hello.

I am concerned. Often, the worst headache of life is due to a ruptured aneurysm. It is possible that there is a re-rupture. Please get an MRI as soon as possible. There is no wisdom in suppressing the pain without treating or knowing the root cause.

Regards

[suee115]

I have a friend that had a subarachnoid aneurysm with a rupture in the right temporal lobe, in Dec. 1996. Since then she has had pain at the surgery site. The pain is unrelenting.

She takes several pain killers (narcotics) that only reduce the pain slightly. There are also many side effects.

I promised that I would try to find the cause and help her get the cure. I have been working on it for 9 years.

I have at least found that there are others out there like you, with the same condition.

Where can and do we go from here?


***@****

[FUNCA]

Dr.
In my fathers case he has had  3 CT scans post surgically that show that the swelling and blood spots  have resolved, however, the headache does not show improvement.
Tylenol 3 did not work, therefore his Dr switched to depakote (also in lieu of dilantin) and tramadol.The tramadol  made him very disoriented so we discontinued after 2 days and he became oriented again. Now, the depakote  totally knocks him  out and does not relieve the headache (upset stomach and nausea). The Dr.  has  now recommended that he take vicodin alone. I do not know what  to think , and he really needs relief.  He had a craniotomy on 12/13 for  an unruptured a comm aneurysm.  THank you for your time.

[FUNCA]

my fatheris going through exactly the same thing now. Have your mothers headaches subsided?