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Abstract Details

Characterization of the Prevalence and Treatment Strategies of Migraine in Patients with Refractory Spontaneous Intracranial Hypotension
Headache
P6 - Poster Session 6 (8:00 AM-9:00 AM)
12-003
To characterize the prevalence and management of prior or active migraine and probable migraine in patients diagnosed with and treated for spontaneous intracranial hypotension (SIH).
Spontaneous intracranial hypotension (SIH), characterized by postural headache in the setting of spinal cerebrospinal fluid (CSF) leak or CSF hypotension, is often misdiagnosed as migraine. Patients with SIH may be susceptible to the worsening or development of concomitant headache disorders. In particular, the prevalence of migraine and management strategies for concomitant, new-onset migraine in patients with SIH remains understudied.
Single-center, IRB-approved, retrospective chart review of the electronic medical records of 100 patients aged ≥ 18 with a confirmed or probable diagnosis of SIH evaluated at a tertiary headache center by one SIH specialist from January 1, 2021 to September 1, 2023. Demographics (age, sex, race/ethnicity); migraine history and development, previous and current medication list, and clinical condition (monthly headache days, usual pain intensity, quality of life (MIDAS), acute medication use days, etc.) were extracted.

In the preliminary analysis of 25 patients with confirmed or suspected SIH (mean age = 49, standard deviation = 16), 44% had a past history of migraine or probable migraine. In patients with a history, 82% continued to experience migraine after SIH onset. In contrast, 24% of those with no past history developed new-onset migraine after SIH onset. Altogether, regardless of migraine history, the prevalence of active migraine in patients after SIH onset was 56%. Furthermore, 84% of all patients (100% of patients with active migraine) were on migraine medications at some point in their treatment course.  
Early data suggests that some patients with SIH may have a history of migraine. Even in the absence of migraine history, a subset of patients with SIH may develop new-onset migraine. Migraine medications are a possible management strategy for migraine in patients with SIH.
Authors/Disclosures
Ahmed Taha Shahzad
PRESENTER 		Mr. Shahzad has nothing to disclose.
Victor Wang, MD (Thomas Jefferson University Hospital) Dr. Wang has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Pfizer. Dr. Wang has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Abbvie.
Hsiangkuo Yuan, MD, PhD (Jefferson Headache Center) An immediate family member of Dr. Yuan has received personal compensation for serving as an employee of Merck. Dr. Yuan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Yuan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Yuan has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pfizer. Dr. Yuan has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Salvia. Dr. Yuan has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cerenovous. Dr. Yuan has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Regional Anesthesia and Pain Medicine. Dr. Yuan has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Current Headache and Pain Reports. Dr. Yuan has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MedLink Neurology. Dr. Yuan has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Cephalalgia. The institution of Dr. Yuan has received research support from NIH. The institution of Dr. Yuan has received research support from American Headache Society. The institution of Dr. Yuan has received research support from Pfizer. Dr. Yuan has received publishing royalties from a publication relating to health care. Dr. Yuan has received publishing royalties from a publication relating to health care. Dr. Yuan has received personal compensation in the range of $500-$4,999 for serving as a Grant reviewer with NIH. Dr. Yuan has received personal compensation in the range of $10,000-$49,999 for serving as a Invited speaker with Chinese Stroke Association.
Simy K. Parikh, MD Dr. Parikh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pfizer. Dr. Parikh has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Current Pain and Headache Reports. Dr. Parikh has received personal compensation in the range of $500-$4,999 for serving as a Author with Medlink. Dr. Parikh has received personal compensation in the range of $500-$4,999 for serving as a Faculty with Touch Independent Medical 好色先生 (touchIME) . Dr. Parikh has a non-compensated relationship as a Medical Advisory Board Member with Spinal CSF Leak Foundation that is relevant to AAN interests or activities.