Peri-Incisional Botulinum Toxin for Chronic Postcraniotomy Headache After Traumatic Brain Injury: A Case Series.
Botulinum neurotoxin (BoNT) has been used successfully to treat primary headache syndromes, but there are no published data on its use for chronic postcraniotomy headache. Botulinum neurotoxin type A (BoNT-A) (4:1 dilution) was injected at a dose of 15-50 units into peri-incisional sites of the scalp in 3 patients who had undergone craniotomy remotely for traumatic epidural hematoma. All patients reported reductions in headache lasting at least 2.5 months. Repeat injections were performed in all cases with favorable outcomes. There were no complications. Peri-incisional BoNT-A appears to be a potentially valuable tool in the chronic management of post craniotomy headache after traumatic brain injury.
Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; and Department of Physical Medicine and Rehabilitation, Parkwood Hospital, 801 Commissioners Road East, St. Joseph's Health Care London, London, Ontario N6C 5J1, Canada.
Heather M
HM
MacKenzie
Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; and Department of Physical Medicine and Rehabilitation, Parkwood Hospital, St. Joseph's Health Care London, London, Ontario, Canada.
Robert
R
Teasell
Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; and Department of Physical Medicine and Rehabilitation, Parkwood Hospital, St. Joseph's Health Care London, London, Ontario, Canada.
Thomas A
TA
Miller
Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; and Department of Physical Medicine and Rehabilitation, Parkwood Hospital, St. Joseph's Health Care London, London, Ontario, Canada.
Keith
K
Sequeira
D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D001930:Brain Injuries / Q000601:surgery*; D003399:Craniotomy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D020773:Headache Disorders / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D011300:Preoperative Care / Q000379:methods*; D055815:Young Adult
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A