Headache after resection of acoustic neuroma.
Long-lasting severe headaches are reported to occur in up to 83% of patients who have undergone resection of acoustic neuroma, especially through a suboccipital approach. These headaches, however, are not well defined. The objective of this study was to assess the frequency and character of new-onset headaches after resection of acoustic neuroma by a suboccipital approach with cranioplasty. Review of the medical record was followed by a telephone interview with 48 patients (67% female; mean age, 52 years) who had undergone resection of an acoustic neuroma through a suboccipital craniotomy during the 2 years before the study. Of the 48 patients, 58% had post-operative head pain that lasted more than 7 days and could be categorized into two types. A moderate to severe, short-term head pain with gradual resolution occurred in 35% of the patients, and a mild, unremitting pain was reported by 23%. Both types of pain had a dull ache or pressure quality and were adjacent to or confined to the incisional area. Overall, 77% of the patients were pain-free within 4 months after operation. Age, sex, tumor size, or preoperative history of headache did not influence development of the postoperative pain. We found that new-onset headache after resection of acoustic neuroma by a suboccipital approach with cranioplasty is much less common than previously reported and is best described as mild incisional pain rather than a severe headache. The literature regarding headaches after different surgical approaches for acoustic neuroma resection is reviewed, and possible explanations for development of the pain are discussed.
Mosek
A C
AC
Department of Neurology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA.
Dodick
D W
DW
Ebersold
M J
MJ
Swanson
J W
JW
D000328:Adult; D015331:Cohort Studies; D003399:Craniotomy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods; D010149:Postoperative Pain / Q000175:diagnosis* / Q000209:etiology; D015995:Prevalence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome