Headache in patients with non-functioning pituitary adenoma before and after transsphenoidal surgery – a prospective study
Authors' conclusion
The study supports that clinically significant and long-lasting improvements of disabling headache and QoL can be achieved with TSS in a substantial number of patients with NFPA.
Study context
- Population
- Consecutive patients with non-functioning pituitary adenoma (NFPA) undergoing transsphenoidal surgery (TSS), September 2015 to December 202127 with disabling headache
- Participants
- 101 patients
- Exposure
- Headache before vs 12 months after TSS
- Preoperativen = 101reference
- Outcome
- Headache assessed by MIDAS questionnaire
- Follow-up
- 12-months post-surgery
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Median total Migraine Disability Assessment (MIDAS) score improved
from 60 (IQR: 19-140) to 10 (IQR: 0-49)
P = 0.004
Observational data: associations, not effects.
Further findings
Disabling preoperative headache
- Patients with disabling preoperative headache
- 27 (27%)
Headache frequency over a 90-day period, patients with disabling preoperative headache · 12 months post-surgery
- Headache frequency decreased (days)
- from 45 (IQR: 25-83) to 6 (IQR: 3-36) days (P = 0.002)
Headache intensity, patients with disabling preoperative headache · 12 months post-surgery
- Headache intensity decreased
- from 5 (IQR: 4-7) to 4 (IQR: 2-7) (P = 0.016)
Change in headache, 27 patients with preoperatively disabling headache · 12 months post-surgery
- Clinically relevant improvement
- 18 (67%)
- Deterioration
- 4 (15%)
- Unchanged
- 5 (19%)
EQ-VAS score, patients with clinically relevant headache improvement · 12 months post-surgery
- EQ-VAS score improved
- from 50 (IQR: 30 - 7) to 80 (IQR: 65-86) (P < 0.001)
New postoperative headache, 74 patients with no preoperative headache
- Developed postoperative headache
- 11 (15%)
Predictors of postoperative headache relief
- No clinical factors predicting postoperative headache relief identified
Safety
New postoperative headache in patients without preoperative headache
- Developed postoperative headache (of 74 patients)
- 11 (15%)
Original publication
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