Abstract Details

Title Quality of Life in Patients with Confirmed and Suspected Spontaneous Intracranial Hypotension

Topic Headache

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 2-002

Objective To assess the impact of spontaneous intracranial hypotension (SIH) on quality-of-life (QoL).

Background SIH is a debilitating condition that typically produces orthostatic headache and limits upright time. It is often difficult to detect, diagnose, and treat, profoundly affecting patients’ QoL.

Design/Methods We conducted a cross-sectional survey of patients with confirmed (n=59) and clinically suspected (n=36) SIH evaluated from 2016 to 2022. Participants completed the following validated measurements online (REDCap V 11.2.2): SF-36 (general well-being), PHQ-9 (depression), GAD-7 (anxiety), FACIT-Sp-12 (spiritual well-being), and HIT-6 (headache impact). Subsequently, willing participants were interviewed to administer the Columbia-Suicide Severity Rating Scale (C-SSRS) assessing suicidal behavior and ideation.

Results 95 of 234 patients (41%) meeting inclusion criteria completed the questionnaires. The average age was 51.1 years (SD: 15.5), predominantly female (69.5%), Caucasian (91.6%), and married (69.5%). 74.5% scored within the most severe headache category on the HIT-6. SF-36 scores were significantly worse (p < 0.0001) compared to the general population. 49.1% scored in the moderate or worse depression range (>10) and 25.4% scored for moderate or worse anxiety (>10). FACIT scores strongly correlated (p<0.001) with HIT-6 (-.54), SF-36 Mental Component (r=.66), PHQ-9 (r=-.65) and GAD-7 (r=-.65). 67 respondents completed the C-SSRS of whom 64.2% had endorsed a wish to be dead, and 22.4% had demonstrated suicidal behavior. Symptom-free SIH patients (n = 22) scored significantly better than symptomatic patients and similar to the general population.

Conclusions SIH is associated with severe headache pain and high rates of depression, anxiety, and disability, affecting basic activities of daily living. Individuals with confirmed and suspected SIH had similar levels of head pain, depression, anxiety and suicidality in our cohort. Symptom-free individuals following successful treatment or spontaneous remission showed improved outcomes comparable to the general population. Improved identification and treatment of SIH are imperative to improving patients’ QoL.

Authors/Disclosures
Victor Liaw, MD (UTSW) PRESENTER	Dr. Liaw has nothing to disclose.
Deborah I. Friedman, MD, MPH, FAAN	Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Friedman has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Pfizer. Dr. Friedman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axsome. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Friedman has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie. Dr. Friedman has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Axsone. Dr. Friedman has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Pfizer. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MedLink Neurology . Dr. Friedman has a non-compensated relationship as a Program Co-Chair, Scottsdale Headache Symposium with American Headache Society that is relevant to AAN interests or activities. Dr. Friedman has a non-compensated relationship as a Medical Advisor with Spinal CSF Leak Foundation that is relevant to AAN interests or activities. Dr. Friedman has a non-compensated relationship as a President-elect, Board of Directors with Southern Headache Society that is relevant to AAN interests or activities.
Morgan McCreary	Morgan McCreary has nothing to disclose.

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