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IHS Diagnosis ICD-10
6.5.2 Post-endarterectomy headache [I97.8] G44.814  

Diagnostic criteria:

  1. Acute headache with one of the following sets of characteristics and fulfilling criteria C and D:
    1. diffuse mild pain
    2. unilateral cluster-like pain occurring once or twice a day in attacks lasting 2-3 hours
    3. unilateral pulsating severe pain
  2. Carotid endarterectomy has been performed
  3. Headache, in the absence of dissection, develops within 1 week of surgery
  4. Headache resolves within 1 month after surgery

Comment:

Three subforms of headache have been described after carotid endarterectomy. The most frequent (up to 60% of cases) is a diffuse, mild isolated headache occurring in the first few days after surgery. It is a benign self-limiting condition. The second type (reported in up to 38% of cases) is a unilateral cluster-like pain with attacks, lasting 2-3 hours, occurring once or twice a day. It resolves in about 2 weeks. The third type is part of the rare hyperperfusion syndrome with a unilateral pulsating and severe pain occurring after an interval of 3 days after surgery. It often precedes a rise in blood pressure and the onset of seizures or neurological deficits on about the 7th day. Urgent treatment is required since these symptoms can herald cerebral haemorrhage.