Severe headache trajectory following aneurysmal subarachnoid hemorrhage: the association with lower sodium levels.
Robert S Eisinger, Zachary A Sorrentino, Brandon Lucke-Wold and 5 others
PMID 35353644WHAT IT FOUND
Most aneurysm patients had stable severe headache.
Those with persistent severe pain were younger and had slightly lower morning sodium levels than those with mild pain. Sodium levels may signal pain severity but do not prove low sodium causes the headache.
Key findings
01Two distinct headache trajectories emerged: a mild-moderate group (29%) where pain decreased, and a moderate-severe group (71%) where pain remained stable over 12 days.
02Patients in the moderate-severe headache group had lower average morning sodium levels (137.5 mmol/L) compared to the mild-moderate group (139.3 mmol/L).
03The moderate-severe headache group was significantly younger (mean age 54.4 years) than the mild-moderate group (mean age 64.3 years).
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study is retrospective and single-center, limiting generalizability. Patients who could not verbally report pain for more than 4 days were excluded, meaning results do not apply to those with severe consciousness impairment. The association between lower sodium and severe headache is correlational; it cannot be determined whether low sodium causes headache or if headache/pain medication use leads to lower sodium. Analgesic use was not standardized across patients, which may have influenced pain trajectories. The sample size of 91 patients is relatively small for identifying distinct clinical subgroups.
Declared interests
The authors declare no conflicts of interest. The study was supported by the National Institutes of Health (N.I.H., Extramural).
The easy way to misread this
Do not interpret the lower sodium levels in the severe headache group as evidence that correcting sodium will relieve pain. The study shows an association, but the direction of causality is unknown; pain itself or the medications used to treat it may have contributed to the lower sodium levels.