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DOI: 10.1055/s-0041-1729180
Headache Before and After Endoscopic Transsphenoidal Pituitary Tumor Surgery: A Prospective Study
Funding The study was supported by grants from the Swedish state under an agreement between the Swedish government and County Councils, the ALF-agreement (ALFGBG-719531 and ALFGBG-772591), and by grants from the Health & Medical Care Committee of the Region Västra Götaland, Sweden and The Swedish Society of Medicine (SLS-884901). T.S. reports grants from Health & Medical Care Committee of the Region Västra Götaland, Sweden, during the conduct of the study; personal fees from Lecture fees from Abbott, outside the submitted work.
Abstract
Objective Headache is a common symptom among patients with pituitary tumors, as it is in the general population. The aim of the study was to investigate headache as a symptom in patients with pituitary tumors before and 6 months after endoscopic transsphenoidal surgery (TSS).
Design This is a prospective observational cohort study.
Setting This study was conducted at university tertiary referral hospital.
Participants A total of 110 adult patients underwent endoscopic TSS for pituitary tumors.
Main Outcome Measures The Migraine Disability Assessment (MIDAS) questionnaire was used before and 6 months after surgery for the assessment of headache. Clinical variables with potential influence on headache were analyzed.
Results Sixty-eight (62%) patients experienced headaches at least once during the 3 months before surgery. Thirty (27%) patients reported disabling headache before surgery, with younger age being an independent associated factor (p < 0.001). In patients with disabling headache before surgery, the median (interquartile range) MIDAS score improved from 78 (27–168) to 16 (2–145; p = 0.049), headache frequency decreased from 45 (20–81) to 14 (4–35) days (p = 0.009), and headache intensity decreased from 6 (5–8) to 5 (4–7) (p = 0.011) after surgery. In total, 16 of the 30 (53%) patients reported a clinically relevant improvement and five (17%) a clinically relevant worsening. Four (5%) patients developed new disabling headache. No predictor for postoperative improvement of headache was identified.
Conclusion In this prospective study, the results show that disabling headache improves following endoscopic TSS in a subset of patients with pituitary tumors. However, no predictive factors for improvement could be identified.
* These authors contributed equally to this study.
Publikationsverlauf
Eingereicht: 07. Januar 2021
Angenommen: 28. Februar 2021
Artikel online veröffentlicht:
29. Mai 2021
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