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Headache Disability Index
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Supplemental–Highly Recommended: Chiari I Malformation (CM)
Short Description of Instrument

Patient-reported outcome instrument to determine headache disability level.


The Headache Disability Index (HDI) is a 27-item questionnaire.The first two questions asks the patient to identify the frequency (1 per month; more than 1 but less than 4 per month; more than 1 per week) and intensity (mild, moderate, severe) of their headache. The remaining questions evaluate quality of life issues to determine headache disability.

1. Using this system, if "YES" is checked on any given line, that answer is given 4 points; a "SOMETIMES" answer is given 2 points and a "NO" answer is given zero.
2. Using this system, a score of 10–28% is considered to constitute mild disability; 30–48% is moderate; 50–68% is severe; 72% or more is complete.

Headache is the most common symptom in Chiari I malformation patients. In the study by Parker et al. (2013) the mean preoperative and postoperative HDI scores were 51.6 and 33.9 respectively, an improvement of 17.7 after surgery. Recording the HDI before and after surgery for Chiari I malformation will provide a standard and replicable way to quantitate the headache response to different surgical procedures for Chiari I malformation.

Jacobson GP, Ramadan NM, Aggarwal SK, Newman CW. The Henry Ford Hospital Headache Disability Inventory (HDI). Neurol. 1994;44(5):837-842.
Parker SL, Godil SS, Zuckerman SL, Mendenhall SK, Tulipan NB, McGirt MJ. Effect of symptomatic pseudomeningocele on improvement in pain, disability, and quality of life following suboccipital decompression for adult Chiari malformation type I. J Neurosurg. 2013;119(5):1159-1165.


Document last updated June 2019