Incidence of headache as a presenting complaint in over 1000 patients with sellar lesions and factors predicting postoperative improvement

Clinical Neurology and Neurosurgery
Arman JahangiriManish Kumar Aghi

Abstract

Due to the high incidence of headaches and pituitary tumors, neurosurgeons often evaluate patients with benign-appearing sellar lesions and headaches without insight into whether the headache is attributable to the lesion. We sought to evaluate the incidence of headache as a presenting complaint in patients undergoing transsphenoidal surgery for various pathologies and to identify factors predicting postoperative improvement. We conducted a 5-year retrospective review of our first 1015 transsphenoidal surgeries since establishing a dedicated pituitary center. Of 1015 patients, 329 (32%) presented with headache. Of these 329 patients, 241 (73)% had headache as their chief complaint. Headache was most common in patients with apoplexy (84%), followed by Rathke's cleft cysts (RCCs) (60%). Multivariate analyses revealed diagnosis (P = 0.001), younger age (P = 0.001), and female gender (P = 0.006) to be associated with headache. Of patients presenting with headaches, 11% reported improvement at 6-week follow-up and 53% improved at 6-month follow-up. Multivariate analyses revealed gross total resection (GTR; P = 0.04) and decreased duration of headache (P = 0.04) to be associated with improvement, while diagnosis, age, gender, lesion ...Continue Reading

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Jul 31, 2013·Journal of Neurosurgery·Arman JahangiriManish K Aghi

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Citations

May 2, 2016·World Neurosurgery·Gøril Bruvik GravdahlOle Solheim
Jul 10, 2018·Journal of Pediatric Endocrinology & Metabolism : JPEM·Monika Prokop-PiotrkowskaMieczysław Szalecki
Jul 31, 2019·Current Pain and Headache Reports·Himanshu Suri, Carrie Dougherty
Jul 9, 2020·Clinical Medicine Insights. Endocrinology and Diabetes·Mussa H AlMalkiSalem A Beshyah
Jul 6, 2018·Current Pain and Headache Reports·Laura E Donovan, Mary R Welch
Nov 29, 2021·World Neurosurgery·Gina WatanabeDavid Cory Adamson

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