Significant headache improvement after transsphenoidal surgery in patients with small sellar lesions: Clinical article

Maria Fleseriu, Christine Yedinak, Caitlin Campbell, Johnny B. Delashaw

Research output: Contribution to journalArticle

42 Scopus citations

Abstract

Object. Pituitary adenomas represent a large proportion of brain tumors that are increasing in incidence because of improved imaging techniques. Headache is the primary symptom in patients with large tumors (macroadenomas), but is also a symptom in patients with small tumors (microadenomas, tumors < 1.0 cm). The prevalence and optimal treatment of headaches associated with pituitary tumors is still unclear, particularly in cases of microadenoma. If conventional medical management fails, transsphenoidal surgery (TSS) may be considered as an alternative treatment for intractable headaches. Methods. The authors conducted a retrospective review of 512 patients who underwent TSS at Oregon Health & Science University between 2001 and 2007; patients with Cushing disease were excluded. The authors identified 41 patients with small pituitary tumors who underwent TSS, and retrospectively evaluated the resolution and/or treatment of headache. Results. Ninety percent of patients who presented with nonfunctioning microadenomas and Rathke cleft cysts experienced resolution or improvement in their headaches after TSS, and 56% of patients who presented with hyperfunctioning pituitary microadenomas had improvement in their headaches. There were no postoperative complications. Conclusions. In this retrospective study, the authors demonstrate the efficacy of TSS in the treatment of intractable headaches in patients who present with pituitary microadenomas (nonsecreting and hypersecretory) and Rathke cleft cysts.

Original languageEnglish (US)
Pages (from-to)354-358
Number of pages5
JournalJournal of neurosurgery
Volume110
Issue number2
DOIs
StatePublished - Feb 1 2009

Keywords

  • Headache
  • Pituitary microadenoma
  • Transsphenoidal surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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