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Prevalence and Impact of Postoperative Headaches in Nonfunctioning Pituitary Macroadenoma Patients: A Longitudinal Cohort Study

Authors
 Min Kyeong Jang  ;  Chang Gi Park  ;  Seonguk Jang  ;  Eui Hyun Kim 
Citation
 WORLD NEUROSURGERY, Vol.133 : e633-e639, 2020-01 
Journal Title
WORLD NEUROSURGERY
ISSN
 1878-8750 
Issue Date
2020-01
MeSH
Adenoma / complications* ; Adenoma / surgery* ; Adult ; Aged ; Cohort Studies ; Female ; Headache / epidemiology* ; Headache / etiology* ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Neurosurgical Procedures ; Pituitary Neoplasms / complications* ; Pituitary Neoplasms / surgery* ; Prevalence ; Quality of Life ; Treatment Outcome ; Young Adult
Keywords
Headache ; Pituitary adenoma ; Transsphenoidal surgery
Abstract
Background: Patients with nonfunctioning pituitary macroadenomas commonly experience headaches before and after surgery, and headaches have been reported to significantly detract from the quality of life. Despite this adverse impact, few studies have examined the prevalence and pattern of headaches on a long-term basis. Thus, this study employed a longitudinal cohort design to identify headache prevalence and severity during a 6-month postoperative period and its predictors.

Methods: Forty patients with nonfunctioning pituitary macroadenomas who underwent transsphenoidal surgery were enrolled as subjects, and Headache Impact Test-6 (HIT-6) was performed at 4 time points: before and 1, 3, and 6 months after surgery.

Results: This study revealed that patients with nonfunctioning pituitary macroadenoma suffered from headaches at each of the 4 time points and that 37.5%, 27.8%, 17.9%, and 12.8% of the patients experienced "substantial and severe impact headaches" before and 1, 3, and 6 months after surgery, respectively. In addition, total HIT-6 scores 1 month after surgery were a significant predictor (B = 0.41, P < 0.001) of headaches 3 and 6 months after surgery. Among the HIT-6 items, pain (B = 0.09, P < 0.001), cognitive function (B = 0.07, P < 0.001), and psychological distress (B = 0.07, P < 0.001) showed the greatest impact on long-term headaches.

Conclusion: Headaches adversely affected patients even 6 months after surgery. In addition, headaches 1 month after surgery predicted the prevalence of long-term headaches at 3 and 6 months, demonstrating the importance of timely postsurgical measurement of headaches to anticipate patients' long-term headache patterns.
Full Text
https://www.sciencedirect.com/science/article/pii/S1878875019325653
DOI
10.1016/j.wneu.2019.09.123
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Eui Hyun(김의현) ORCID logo https://orcid.org/0000-0002-2523-7122
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180603
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