- Availability, Accessibility, and Utilization of Diagnostics and Therapeutics for Spontaneous Intracranial Hypotension in Asia
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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
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Headache Pain Res. 2025;26(2):142-153. Published online June 16, 2025
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DOI: https://doi.org/10.62087/hpr.2025.0005
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 Abstract
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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.
- Migraine in Women: Inescapable Femaleness?
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Soo-Kyoung Kim
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Headache Pain Res. 2024;25(1):1-2. Published online April 24, 2024
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DOI: https://doi.org/10.62087/hpr.2024.0010
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Citations to this article as recorded by  - Calcitonin Gene-Related Peptide Monoclonal Antibody Treatment in Nine Cases of Persistent Headache Following COVID-19-Infection
Soyoun Choi, Yooha Hong, Mi-Kyoung Kang, Tae-Jin Song, Soo-Jin Cho
Journal of Korean Medical Science.2025;[Epub] CrossRef - Morning Headaches: An In-depth Review of Causes, Associated Disorders, and Management Strategies
Yooha Hong, Mi-Kyoung Kang, Min Seung Kim, Heejung Mo, Rebecca C. Cox, Hee-Jin Im
Headache and Pain Research.2025; 26(1): 66. CrossRef
- Diagnostic Delay of Cluster Headache in Korea
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Byung-Su Kim, Soo-Kyoung Kim, Pil-Wook Chung, Byung-Kun Kim, Mi Ji Lee, Min Kyung Chu, Jin-Young Ahn, Dae Woong Bae, Tae-Jin Song
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Published online June 30, 2020
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- 국내 군발두통의 진단지연
- A Case of Superior Orbital Fissure Syndrome Attributed to Sinusitis Presenting Unilateral Throbbing Headache
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Byung-Su Kim, Byung-Kun Kim, Soo-Kyoung Kim, Jae-Moon Kim, Heui-Soo Moon, Kwang-Yeol Park, Jong-Hee Sohn, Tae-Jin Song, Min Kyung Chu, Myoung-Jin Cha, Soo-Jin Cho, J
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Published online December 31, 2017
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- 두통 초진 환자에서 이차두통의 임상적 예측인자: 다기관 연구
- The Frequency and Characteristics of Other Primary Headache Disorders in First-Visit Headache Patients in Korea: A Multicenter Study
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Myoung-Jin Cha, Byung-Kun Kim, Byung-Su Kim, Jong-Hee Sohn, Soo-Kyoung Kim, Heui-Soo Moon, Tae-Jin Song, Jae-Moon Kim, Jeong Wook Park, Min Kyung Chu, Kwang-Yeol Park
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Published online December 31, 2017
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- 신경과 외래를 방문한 두통 초진 환자에서 기타 원발두통의 빈도와 특징 - 다기관 연구
- A Case of Cavernous Sinus Meningioma Mimicking Cluster Headache
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Ji-Ho Hong, Tae-Won Yang, Hong-Seop Yeom, Soo-Kyoung Kim
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Published online December 31, 2013
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- 군발두통으로 오인된 해면정맥굴 수막종 1례
- Interictal Burden of Migraine: A Narrative Review
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Soo-Kyoung Kim, Todd J. Schwedt
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Received September 14, 2025 Accepted October 5, 2025 Published online October 13, 2025
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DOI: https://doi.org/10.62087/hpr.2025.0018
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Abstract
- Migraine is a chronic neurological disorder associated with substantial disability and societal costs. Traditionally, research and clinical care have focused on the ictal phase, characterized by headache and accompanying symptoms. However, growing evidence suggests that a considerable portion of migraine-related disability occurs between attacks, known as the interictal burden (IIB). IIB encompasses a wide spectrum of cognitive, emotional, sensory, and functional impairments that persist during headache-free periods, including fatigue, allodynia, photophobia, cognitive dysfunction, anticipatory anxiety, and social withdrawal. These symptoms can markedly reduce quality of life, work productivity, and family functioning, even in individuals with infrequent attacks. In a descriptive survey of 506 migraine respondents, 67% experienced severe IIB. The effects of IIB extend beyond patients themselves, contributing to presenteeism in the workplace and imposing emotional and logistical strain within families. Several instruments, including the Migraine Interictal Burden Scale (MIBS-4), Migraine-Specific Quality of Life Questionnaire (MSQ v2.1), Headache Impact Test (HIT-6), and Migraine Disability Assessment (MIDAS), have been employed to assess different dimensions of IIB. Nonetheless, no single comprehensive and standardized tool fully captures the multidimensional nature of IIB. Recognizing and addressing IIB is essential for delivering holistic, patient-centered migraine care. Future research should focus on developing validated assessment instruments and incorporating IIB measures into clinical trials and routine practice to better understand and alleviate the hidden burden of migraine.
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