Sakit Kepala yang dihubungkan dengan Cedera Otak Traumatik - Bisri, Dewi Yulianti; Bisri, Tatang (Majalah Anestesia dan Critical Care, 2014)
Sakit kepala adalah salah satu keluhan yang sering setelah cedera otak traumatik (COT) dan disebut sebagai “post-traumatic headache” sakit kepala pascatrauma. Berkisar 30–90% pasien mengalami sakit kepala setelah cedera. Sakit kepala setelah COT dapat berlangsung lama, datang dan hilang dalam waktu satu tahun, menyulitkan melakukan aktivitas sehari-hari, sulit berfikir dan mengingat sesuatu. Setelah cedera kepala berat, pasien mungkin mengalami sakit kepala akibat dari operasi pada tulang kepalanya atau masih adanya kumpulan kecil darah atau cairan di ruang intrakranial. Sakit kepala bisa setelah cedera kepala ringan, sedang dan berat. Sakit kepala ini dapat disebabkan berbagai kondisi antara lain perubahan dalam otak akibat cedera, cedera leher dan tulang kepala yang belum pulih seluruhnya, tegangan dan stres, atau efek samping pengobatan. Ada beberapa tipe sakit kepala antara lain sakit kepala tipe migraine, tension, cervicogenic, dan rebound. Terapi dapat dilakukan dengan merubah pola hidup misalnya harus cukup tidur, olah raga, hindari kopi, hindari makanan tertentu yang memicu sakit kepala seperti anggur (red wine), monosodium glutamat, keju dan terapi obat-obatan misalnya asetaminophen, gabapentin, antidepresant. Akan tetapi, lebih utama adalah pencegahan dengan cara menghindari cedera otak primer, dan apabila terjadi cedera otak primer sebaiknya menghindari dan mengobati cedera otak sekunder dengan pengelolaan perioperatif yang tepat. Kata kunci: Bedah saraf, cedera otak traumatik, neuroanestesi, sakit kepala Headache is one of the most common symptoms after traumatic brain injury (TBI) and called “post-traumatic headache”. Approximately 30–90% of people having headaches. Headaches after TBI can be long-lasting, coming and going even past one year. Headaches can make it hard for you to carry out daily activities or can cause you to have more difficulty thinking and remembering things. Right after a severe TBI, people may have headaches because of the surgery on their skulls or because they have small collections of blood or fluid inside the skull. Headaches can also occur after mild, moderate and severe TBI. These headaches can be caused by a variety of conditions, including a change in the brain caused by the injury, neck and skull injuries that have not yet fully healed, tension and stress, or side effects from medication.There are many kinds of headaches,migraine headaches, tension-type headaches, cervicogenic headaches, and rebound headaches. Treatment a headache after TBI will depend on each individual case. They are lifestyle changes like get enough sleep, get daily exercise, avoid caffeine, avoid certain foods that may trigger a headache, like red wine, monosodium glutamate or certain cheeses, and medicine therapy as acetaminophen, gabapentin, antidepresant. But, more important is prevention with avoid primary brain injury and avoid and treatment secondary brain injury with adequate periopeative management. Key words: headache, neuroanesthesia, neurosurgery, traumatic brain injury Reference Levin M, Ward TN. Headache. Dalam: Silver JM, McAllister TW, Yudofsky SC, penyunting. Textbook of traumatic brain injury. Edisi ke-2. Washington: American Psychiatric Pub Inc;2011,343–50. Lew HL, Lin PH, Fuh JL, Wang SJ, Clark DJ, Walker WC. Characteristics and treatment of headache after traumatic brain injury: A focused review. Am J Phys Med Rehabil 2006;85(7):619–27. Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro C A. Mild traumatic brain injury in U.S. Soldiers returning from Iraq. N Engl J Med 2008;358(5):453–63. Mihalik JP, Stump JE. Collins MW, Lovell MR, Field M, Maroon JC. Posttraumatic migraine characteristics in athletes following sports-related cocussion. J Neurosurg 2005;102(5):850–55. Hofman JM, Lucas S, Dikmen S, Braden CA, Brown AW, Brunner R, dkk. Natural history of headache after traumatic brain injury. Journal of Neurotrauma 2011;28:1719–25. Walker WC, Seel RT, Curtiss G, Warde DL. Headache after moderate and severe traumatic brain injury: a longitudinal analysis. Arch Phys Med Rehabil 2005;86:1793–800. Sherman KB, Goldberg M, Bell KR. Traumatic brain injury and pain. Phys Med Rehabil Clin N Am. 2006;17:473–90. De Lima Martin HA, Ribas VR, Martins BBM, Ribas RMG, Valenca MM. Posttraumatic headache. Arq Neuropsiquiatr 2009;67(1):43–45. McAllister TW. Mild brain injury. Dalam: Silver JM, McAllister TW, Yudofsky SC, Penyunting. Textbook of traumatic brain injury. Edisi ke-2. Washington: American Psychiatric Pub Inc;2011. hlm. 239–57. Lew Hl, Lin Pri, Fuh JL, Wong SJ, Clark DJ, Walker WC. Characteristic and treatment of headache after traumatic Broun Injury: a focused review. Am J Phys Med Rehabil. 2006;85(7):619–27