Headache and Pain Research

Mamoru Shibata

2 Articles

Availability, Accessibility, and Utilization of Diagnostics and Therapeutics for Spontaneous Intracranial Hypotension in Asia: Soyoun Choi, Woo-Seok Ha, Soo-Jin Cho, Aynur Özge, Betül Baykan, Esme Ekizoglu, Kiratikorn Vongvaivanich, Koichi Hirata, Linh Tuyen Nguyen, Mamoru Shibata, Min Kyung Chu, Otgonbayar Luvsannorov, Ryotaro Ishii, Shengyuan Yu, Shih-Pin Chen, Shuu-Jiun Wang, Takao Takeshima, Tsubasa Takizawa, Vinh Khang Nguyen, Wei-Ta Chen, Yen-Feng Wang, Soo-Kyoung Kim, Mi Ji Lee; Headache Pain Res. 2025;26(2):142-153. Published online June 16, 2025; DOI: https://doi.org/10.62087/hpr.2025.0005

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Purpose: Recent advances in imaging techniques have significantly enhanced the diagnosis of spontaneous intracranial hypotension (SIH). However, these developments have been reported mostly in Europe and the United States. This study aimed to evaluate the availability and utilization of diagnostic and treatment modalities for SIH in Asia, through a survey of regional headache specialists.
Methods
A literature search was conducted using PubMed, and members of the Asian Regional Consortium for Headache were contacted. Participants completed a two-step survey evaluating the availability, accessibility, and frequency of SIH diagnostic and treatment methods in their countries and institutions. Descriptive statistics were used to analyze the data.
Results
Twenty physicians from eight countries completed both rounds of the survey. Lumbar puncture, brain magnetic resonance imaging (MRI), and spinal MRI are widely available across Asia, but real-time imaging techniques—such as dynamic computed tomography myelography and digital subtraction myelography—that precisely localize cerebrospinal fluid leaks are less accessible. Blind or semi-targeted epidural blood patches (EBPs) are available at most centers, but are easily accessible in only about half of cases. Surgical interventions are rarely available.
Conclusion
Most diagnostic methods for SIH are available in Asia, despite some regional disparities. The utilization of EBP and surgical interventions remains somewhat limited. This highlights the need for greater awareness and standardization of diagnostic methods in Asia.

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Temporal and regional trends in the diagnosis and treatment of spontaneous intracranial hypotension: a systematic review
Woo-Seok Ha, Soyoun Choi, Mi-Kyoung Kang, Hye Yun Kim, Soo-Jin Cho, Soo-Kyoung Kim, Mi Ji Lee
The Journal of Headache and Pain.2026;[Epub] CrossRef
Diagnostic Value of Flow-Void Sign for Localizing Ventral Dural Defects in Spine MRI
Soo-Im Jang, Soyoun Choi, Seung Ae Kim, Hoe Jong Jeong, Ja-Young Choi, Mi Ji Lee
Journal of Clinical Neurology.2026; 22(3): 364. CrossRef
Current Concepts in the Diagnosis and Management of Spontaneous Intracranial Hypotension
Woo-Seok Ha, Min Kyung Chu
Journal of the Korean Neurological Association.2026; 44(2): 110. CrossRef
Surgical Treatment of Spontaneous Intracranial Hypotension: Clinical Characteristics and Outcomes in a Surgically Treated Cohort of Type 1 and Type 3 Leaks
Woo-Seok Ha, Hyun Woong Mun, Soomi Cho, Chang Kyu Lee, Dong Ah Shin, Seong Yi, Keung Nyun Kim, Min Kyung Chu, Yoon Ha
Journal of Clinical Medicine.2026; 15(13): 4972. CrossRef
Recommendations for the Management of Spontaneous Intracranial Hypotension With Spinal Longitudinal Epidural CSF Collection
Soyoun Choi, Ian Carroll, Deborah I. Friedman, Peter G. Kranz, Eugene Lee, Manjit Matharu, Simy Parikh, Henrik W. Schytz, Marcio Nattan Portes Souza, Yen-Feng Wang, Hsiangkuo Yuan, Mi Ji Lee
Neurology.2026;[Epub] CrossRef

Prevalence of Gastrointestinal Disorders in Patients with Migraine: An Insurance Claims Database Study in Japan: Eiichiro Nagata, Miki Hasebe, Daishi Yui, Alex Wang, Robert Urman, Katarzyna Jabłońska, Renata Majewska, Mamoru Shibata; Received August 21, 2026 Accepted October 13, 2026 Published online October 27, 2026; DOI: https://doi.org/10.62087/hpr.2026.0038

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Abstract: Purpose: Migraine is often associated with gastrointestinal (GI) comorbidities. This study estimated the 1-year prevalence of five GI disorders in patients with and without migraine.
Methods
This cross-sectional study used data from a Japanese health insurance claims database for two periods: April 1, 2019–March 31, 2020, and April 1, 2020–March 31, 2021. Individuals with a migraine diagnosis or a triptan prescription constituted the migraine group, and those with at least two non-migraine claims constituted the non-migraine group. The 1-year prevalence was assessed for any constipation, refractory constipation, constipation-predominant irritable bowel syndrome (IBS-C), diarrhea, and diarrhea-predominant irritable bowel syndrome (IBS-D).
Results
The migraine and non-migraine groups included 75,720 and 993,198 patients, respectively, in Period 1 and 82,945 and 978,071 patients, respectively, in Period 2. The 1-year prevalence of any constipation in the migraine and non-migraine groups was 12.1% (95% confidence interval [CI]: 11.9%–12.4%) and 5.9% (95% CI: 5.9%–6.0%), respectively. The corresponding prevalence estimates were 2.0% (95% CI: 1.9%–2.1%) and 0.8% (95% CI: 0.8%–0.8%) for refractory constipation; 1.5% (95% CI: 1.4%–1.6%) and 0.5% (95% CI: 0.5%–0.5%) for IBS-C; 4.5% (95% CI: 4.3%–4.6%) and 2.1% (95% CI: 2.1%–2.2%) for diarrhea; and 2.1% (95% CI: 2.0%–2.2%) and 0.6% (95% CI: 0.6%–0.6%) for IBS-D. Among patients with migraine, any constipation was present in 21.4% (95% CI: 21.0%–21.8%) of those prescribed prophylactic medication and 3.2% (95% CI: 3.0%–3.3%) of those not prescribed such medication.
Conclusion
Physicians should recognize how frequently GI disorders occur in patients with migraine, discuss these conditions with patients, and advise them on appropriate management.

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