SAT615 Long-term Effects Of Transsphenoidal Surgery On Headache In Patients With Pituitary Tumors - A Prospective Study

Abstract

Abstract Disclosure: V. Hantelius: None. O. Ragnarsson: None. G. Johannsson: None. E. Thurin: None. T. Skoglund: None. T. Hallen: None. Objective: Headache is a common symptom in patients with non-functioning pituitary adenomas (NFPA). The aim of this study was to analyze the long-term effect of transsphenoidal surgery (TSS) on disabling headache in patients with NFPA and to investigate possible predictive factors for headache relief following TSS. Methods: This was a prospective study of 101 patients with NFPA who underwent TSS between September 2015 to December 2021. Headache was assessed preoperatively and 12 months postoperatively with The Migraine Disability Assessment (MIDAS) questionnaire. MIDAS measures the impact of headache on the everyday life during the last 3 months and assess the headache frequency and intensity. Results: Of 101 patients, 27 (27%) experienced disabling headache preoperatively. In these 27 patients, the median (interquartile range) total MIDAS total score improved from 60 (19-140) to 10 (0-49) (p=0.004; max score 270), headache frequency decreased from 45 (25-83) to 6 (3-36) days per 90 days (p=0.002), and headache intensity decreased from 5 (4-7) to 4 (2-7) (p=0.016; on a scale 0-10 at 12 months after surgery. Overall, 18 of 27 patients (67%) had a clinically relevant improvement of their headache, 4 (15%) had a clinically relevant deterioration and 5 (19%) had no clinically relevant change at one year after surgery. No clinical factors that predicted postoperative headache relief were identified. Conclusions: Our study supports that transsphenoidal surgery achieves clinically significant and long-lasting improvement of disabling headache in patients with NFPA. Presentation: Saturday, June 17, 2023