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

 Min Kyeong Jang  ;  Chang Gi Park  ;  Seonguk Jang  ;  Eui Hyun Kim 
 WORLD NEUROSURGERY, Vol.133 : e633-e639, 2020-01 
Journal Title
Issue Date
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
Headache ; Pituitary adenoma ; Transsphenoidal surgery
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.
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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
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