Efficacy of Therapeutic CSF Drainage in Sub Arachnoid Hemorrhage Patients with SevereHeadache in Tertiary Care Hospital

Objective: This study was carried out with an aim of determining the effectiveness of the therapeutic cerebrospinal fluid (CSF) drainage in the reduction of severe headache in patients who had aneurysmal subarachnoid hemorrhage (SAH). Study Design: Cross-sectional studyPlace and Duration of Study: This study was conducted at the Department of Neurology at the Pak Emirates Military Hospital, Rawalpindi from 16 November 2025 till 16 May 2026. Methods: 90 patients aged 18-70 years with non-traumatic aneurysmal SAH who present themselves with severe headache (Visual Analog Scale 7 or more) were selected using consecutive non-probability sampling. Results: A total of 90 patients were included, with 52 males (57.8%) and 38 females (42.2%), and a mean age of 52.4 ± 10.8 years. Baseline headache severity was high (VAS 8.6 ± 0.9), with WFNS grades I–II observed in 38patients (42.2%) and grades III–V in 52 patients (57.8%). Therapeutic CSF drainage led to progressive reductions in headache intensity, with mean VAS scores of 6.1 ± 1.3 at 24 hours, 5.2 ± 1.4 at 48 hours, and 5.0 ± 1.5 at 72 hours. By 48 hours, 63 patients (70.0%) achieved ≥30% reduction in VAS scores. Safety outcomes were acceptable, with 65 patients (72.2%) experiencing no complications. Conclusion: It was found that therapeutic cerebrospinal fluid (CSF) drainage is a safe and efficacious intervention that can be applied to the reduction of the severity of headache in patients with aneurysmal subarachnoid hemorrhage, leading to the achievement of crucial changes in the severity of pain and overall clinical outcomes.