头痛作为无功能垂体腺瘤和拉特克裂隙囊肿手术的指征：系统回顾

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery Pub Date : 2025-05-24 DOI:10.1016/j.clineuro.2025.108976

Adrianna Wierzbicka , Hediye Gholamshahi , Alireza Soltani Khaboushan , Farhang Rashidi , Mohammadmahdi Sabahi , Mohammad Mofatteh , Anam Baig , Arnaldo Neves Da Silva , Badih Adada , Hamid Borghei-Razavi

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引用次数: 0

摘要

目的头痛是临床常见的症状，往往需要进一步的评估和治疗。本研究旨在全面分析关于头痛作为无功能垂体腺瘤（nfpa）和Rathke裂囊肿（RCCs）患者的绝对手术指征的现有文献，揭示术后头痛的解决方案和手术并发症。方法按照PRISMA指南，使用指定关键词检索PubMed、Scopus、Embase和Web of Science，检索至2023年10月10日。纳入标准包括描述NFPA或RCC患者的研究，其中头痛是唯一的手术指征。提取数据，并使用乔安娜布里格斯研究所（JBI）检查表评估质量。结果共有13项研究符合纳入标准，包括183例因NFPA（ = 111）或RCC（ = 75）引起的头痛接受手术干预的患者。大多数患者头痛改善（75.8% %），而持续性头痛发生率为19.8% %，恶化发生率为4.3% %。头痛复发少见（7.1 %），术后并发症包括短暂性尿囊症（29.4 %）、脑脊液漏（17.6 %）、术后感染（17.6 %）和肾上腺功能不全（17.6 %）。使用JBI检查表进行质量评估，表明各研究存在不同的偏倚风险。结论手术干预可显著改善nfpa和rcc患者的头痛症状，特别是复发少，并发症可控。进一步的前瞻性研究，标准化方案和长期随访是必要的，以验证头痛作为这些患者手术的唯一指征和优化结果。

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Headache as an indication for surgery in non-functioning pituitary adenoma and Rathke's cleft cyst: A systematic review

Purpose

Headaches are a common presentation in clinical practice, often necessitating further evaluation and management. This study aims to comprehensively analyze available literature regarding headaches as an absolute surgical indication for patients with nonfunctioning pituitary adenomas (NFPAs) and Rathke's cleft cysts (RCCs), shedding light on postoperative headache resolution, and surgical complications.

Method

Following PRISMA guidelines, PubMed, Scopus, Embase, and Web of Science were searched until October 10th, 2023, using specified keywords. Inclusion criteria involved studies describing patients with NFPA or RCC, where headache was the sole surgical indication. Data were extracted, and quality assessed using the Joanna Briggs Institute (JBI) checklist.

Results

A total of 13 studies met the inclusion criteria, comprising 183 individuals who underwent surgical intervention for headaches caused by NFPA (n = 111) or RCC (n = 75). The majority of patients experienced headache improvement (75.8 %), while persistent headaches were noted in 19.8 %, and worsening in 4.3 %. Headache recurrence was infrequent (7.1 %), and postoperative complications including transient diabetes insipidus (29.4 %), cerebrospinal fluid leak (17.6 %), postoperative infection (17.6 %), and adrenal insufficiency (17.6 %) were reported. Quality assessment using JBI checklists indicated variable risk of bias across studies.

Conclusion

Surgical interventions significantly improved headache resolution in patients with NFPAs and RCCs, especially with few recurrences and manageable complications. Further prospective research with standardized protocols and long-term follow-up is essential to validate headaches as a sole indication for surgery in these patients and optimize outcomes.

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来源期刊

Clinical Neurology and Neurosurgery 医学-临床神经学

CiteScore

3.70

自引率

5.30%

发文量

358

审稿时长

46 days

期刊介绍： Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.