Immediate post-craniotomy headache.

INTRODUCTION: Headache is the most common adverse event immediately following craniotomy and is due to the surgical procedure and meningeal irritation. OBJECTIVES: The aim of this study was to investigate the prevalence of headache during the first week after a craniotomy, as well as headache intensity, whether pain was registered in the patient's medical records, the use of analgesics and predictors of headache. METHODS: Ninety-one patients who underwent craniotomy were evaluated from the first to the seventh post-operative day. The variables analysed were gender, age, medical history, indication for craniotomy, surgery, occurrence of headache, pain registration in the medical records, length of hospital stay and analgesics consumption. RESULTS: On the second post-operative day, 29.2% of patients had a headache and there was under-reporting of this pain in the patients' records. The analgesics used were non-steroidal anti-inflammatory in 75% of cases. An age of <45 years (odds ratio = 3.0, P = 0.041) and surgery duration lasting >4 hours (odds ratio = 3.7, P = 0.019) were associated with the occurrence of immediate post-craniotomy headache. CONCLUSION: Further training should be provided to professionals caring for patients undergoing craniotomy to better manage post-operative headache.

Ocular melanoma: Keep your eyes open for late brain metastases.

BACKGROUND: The most frequent intraocular malignant tumor is choroidal melanoma (CM). Although brain metastasis is a common feature of other types of cancers, metastasis of CM to the brain is a rare entity. CASE DESCRIPTION: The authors report a case of a 28-year-old woman presenting with a single brain metastasis, 10 years after the treatment of a CM. She underwent a total en-bloc resection of the lesion, and the diagnosis was confirmed histopathologically. The patient concomitantly received whole-brain irradiation therapy combined with chemotherapy, with a survival period of 24 months. CONCLUSION: The present case report draws attention to the necessity of a close and lifelong follow-up of patients treated for this malignancy. The international literature is also reviewed.