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

IF 3.3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Pituitary Pub Date : 2024-10-01 Epub Date: 2024-05-20 DOI:10.1007/s11102-024-01401-3

Victor Hantelius, Oskar Ragnarsson, Gudmundur Johannsson, Daniel S Olsson, Sofie Jakobsson, Erik Thurin, Dan Farahmand, Thomas Skoglund, Tobias Hallen

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引用次数: 0

Abstract

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.

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经蝶窦手术前后无功能垂体腺瘤患者的头痛--一项前瞻性研究。

目的：研究经蝶窦手术（TSS）对无功能垂体腺瘤（NFPA）患者头痛的长期影响，并确定TSS术后头痛缓解的预测因素：我们在2015年9月至2021年12月期间连续对101名接受TSS手术的NFPA患者进行了术前和术后12个月的头痛评估，评估时使用了偏头痛残疾评估（MIDAS）问卷。采用EQ-5D视觉模拟量表（EQ-VAS）评估与健康相关的生活质量（QoL）：101名患者中有27人（27%）在术前出现致残性头痛。其中，MIDAS 总分的中位数从 60（四分位间距 (IQR)：19-140）提高到 10（IQR：0-49）（P = 0.004）。此外，手术后 12 个月时，90 天内的头痛频率从 45 天（IQR：25-83）降至 6 天（IQR：3-36）（P = 0.002），头痛强度从 5（IQR：4-7）降至 4（IQR：2-7）（P = 0.016）。术后 12 个月时，27 位术前头痛致残的患者中有 18 位（67%）的头痛症状有了临床相关的改善，4 位（15%）的头痛症状有所恶化，5 位（19%）的头痛症状保持不变。在头痛有临床相关改善的患者中，EQ-VAS 评分从 50（IQR：30 - 7）提高到 80（IQR：65-86）（P 结论：EQ-VAS 对头痛有临床相关改善：这项研究证实，对相当多的 NFPA 患者来说，使用 TSS 可以使致残性头痛和 QoL 得到明显而持久的改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pituitary 医学-内分泌学与代谢

CiteScore

7.10

自引率

7.90%

发文量

审稿时长

6 months

期刊介绍： Pituitary is an international publication devoted to basic and clinical aspects of the pituitary gland. It is designed to publish original, high quality research in both basic and pituitary function as well as clinical pituitary disease. The journal considers: Biology of Pituitary Tumors Mechanisms of Pituitary Hormone Secretion Regulation of Pituitary Function Prospective Clinical Studies of Pituitary Disease Critical Basic and Clinical Reviews Pituitary is directed at basic investigators, physiologists, clinical adult and pediatric endocrinologists, neurosurgeons and reproductive endocrinologists interested in the broad field of the pituitary and its disorders. The Editorial Board has been drawn from international experts in basic and clinical endocrinology. The journal offers a rapid turnaround time for review of manuscripts, and the high standard of the journal is maintained by a selective peer-review process which aims to publish only the highest quality manuscripts. Pituitary will foster the publication of creative scholarship as it pertains to the pituitary and will provide a forum for basic scientists and clinicians to publish their high quality pituitary-related work.