Department of Endocrinology & Metabolism, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Pituitary Centre Amsterdam, Amsterdam, The Netherlands.
Endocrinol Diabetes Metab. 2024 Jul;7(4):e496. doi: 10.1002/edm2.496.
Sellar masses are common intracranial neoplasms. Their clinical manifestations vary widely and include headache. We aimed to determine whether the prevalence and characteristics of headache in patients with sellar tumours differ from the general population and to investigate the effect of tumour resection on this complaint.
We performed a prospective, controlled study in a single tertiary centre and included 57 patients that underwent transsphenoidal resection for a sellar mass (53% females, mean age 53.5 ± 16.4) and 29 of their partners (controls; 45% females, mean age 54.8 ± 14.9). Outcome measures were prevalence, characteristics and impact of headache 1 month preoperatively and at neurosurgical follow-up 3 months postoperatively.
Preoperatively, the prevalence of regular headache (≥1 time per month) was higher in patients than in controls (54% vs. 17%, p < 0.001), and patients scored higher on headache impact questionnaires (all p ≤ 0.01). At postoperative follow-up, headache prevalence decreased in both groups, but the decrease in regular headache frequency and impact was larger in patients than in controls, and no between-group differences remained.
More than half of patients with sellar tumours suffer from at least once-monthly headaches, and both regular headache occurrence and impact are higher compared with controls. The more pronounced decrease in headache complaints in patients versus controls at postoperative follow-up suggests an additional effect of tumour resection next to the factor time.
鞍区肿块是常见的颅内肿瘤。其临床表现差异很大，包括头痛。我们旨在确定鞍区肿瘤患者头痛的患病率和特征是否与普通人群不同，并研究肿瘤切除对该主诉的影响。
我们在一家单中心进行了一项前瞻性、对照研究，共纳入 57 例接受经蝶窦切除术的鞍区肿块患者（53%为女性，平均年龄 53.5±16.4）和 29 例患者的伴侣（对照组；45%为女性，平均年龄 54.8±14.9）。主要转归为术前 1 个月和术后 3 个月神经外科随访时头痛的患病率、特征和影响。
术前，患者的常规头痛（每月≥1 次）患病率高于对照组（54%比 17%，p<0.001），患者的头痛影响问卷评分均较高（均 p≤0.01）。在术后随访中，两组头痛的患病率均下降，但患者的常规头痛发作频率和影响的下降幅度大于对照组，两组间无差异。
超过一半的鞍区肿瘤患者至少每月有 1 次头痛，且常规头痛的发生和影响均高于对照组。与对照组相比，术后患者头痛主诉的明显减少提示除时间因素外，肿瘤切除还有额外的作用。
