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Headache in patients with non-functioning pituitary adenoma before and after transsphenoidal surgery – a prospective study.

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Název: Headache in patients with non-functioning pituitary adenoma before and after transsphenoidal surgery – a prospective study.
Autoři: Hantelius, Victor, Ragnarsson, Oskar, Johannsson, Gudmundur, Olsson, Daniel S., Jakobsson, Sofie, Thurin, Erik, Farahmand, Dan, Skoglund, Thomas, Hallen, Tobias
Zdroj: Pituitary; Oct2024, Vol. 27 Issue 5, p635-643, 9p
Abstrakt: Purpose: To study the long-term effect of transsphenoidal surgery (TSS) on headache in patients with non-functioning pituitary adenoma (NFPA) and identify factors predicting headache relief following TSS. Methods: We evaluated headache in 101 consecutive patients with NFPA who underwent TSS from September 2015 to December 2021, preoperatively and 12-months post-surgery, by using the Migraine Disability Assessment (MIDAS) questionnaire. Health-related quality of life (QoL) was assessed using the EQ-5D visual analogue scale (EQ-VAS). Results: Of 101 patients, 27 (27%) experienced disabling preoperative headache. Among these, the median total MIDAS score improved from 60 (interquartile range (IQR): 19–140) to 10 (IQR: 0–49) (P = 0.004). Additionally, headache frequency over a 90-day period decreased from 45 (IQR: 25–83) to 6 (IQR: 3–36) days (P = 0.002), and headache intensity decreased from 5 (IQR: 4–7) to 4 (IQR: 2–7) (P = 0.016) at 12-months post-surgery. At 12 months post-surgery, 18 (67%) of 27 patients with preoperatively disabling headache showed clinically relevant improvement of their headache, 4 (15%) showed deterioration, and 5 (19%) remained unchanged. In patients with clinically relevant improvement of their headache, the EQ-VAS score improved from 50 (IQR: 30 − 7) to 80 (IQR: 65–86) (P < 0.001). Of the 74 patients with no preoperative headache, 11 (15%) developed postoperative headache. We identified no clinical factors predicting postoperative headache relief. 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. [ABSTRACT FROM AUTHOR]
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Abstrakt:Purpose: To study the long-term effect of transsphenoidal surgery (TSS) on headache in patients with non-functioning pituitary adenoma (NFPA) and identify factors predicting headache relief following TSS. Methods: We evaluated headache in 101 consecutive patients with NFPA who underwent TSS from September 2015 to December 2021, preoperatively and 12-months post-surgery, by using the Migraine Disability Assessment (MIDAS) questionnaire. Health-related quality of life (QoL) was assessed using the EQ-5D visual analogue scale (EQ-VAS). Results: Of 101 patients, 27 (27%) experienced disabling preoperative headache. Among these, the median total MIDAS score improved from 60 (interquartile range (IQR): 19–140) to 10 (IQR: 0–49) (P = 0.004). Additionally, headache frequency over a 90-day period decreased from 45 (IQR: 25–83) to 6 (IQR: 3–36) days (P = 0.002), and headache intensity decreased from 5 (IQR: 4–7) to 4 (IQR: 2–7) (P = 0.016) at 12-months post-surgery. At 12 months post-surgery, 18 (67%) of 27 patients with preoperatively disabling headache showed clinically relevant improvement of their headache, 4 (15%) showed deterioration, and 5 (19%) remained unchanged. In patients with clinically relevant improvement of their headache, the EQ-VAS score improved from 50 (IQR: 30 − 7) to 80 (IQR: 65–86) (P < 0.001). Of the 74 patients with no preoperative headache, 11 (15%) developed postoperative headache. We identified no clinical factors predicting postoperative headache relief. 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. [ABSTRACT FROM AUTHOR]
ISSN:1386341X
DOI:10.1007/s11102-024-01401-3