title: Transsphenoidal surgery for Rathke’s cleft cyst can reduce  headache severity and frequency.
abstract: OBJECTIVE
  The purpose of this study was to determine the effect of transsphenoidal surgery for Rathke’s cleft cyst(RCC) on headache frequency, severity, and duration.
  
  
  METHODS
  The medical records of 43 consecutive patients who underwent transsphenoidal resection of a pathologically-proven RCC at our institution by the senior author (E.R.L.) between April 2008 and April 2014 were reviewed. Patients were called by telephone and asked to answer questions about the severity, location, type, duration,and quality of their headaches, both pre- and postoperatively.This information was joined with detailed data collected directly from each patient’s medical record regarding headaches upon presentation and at 1-week,6-week, 3-month, and annual post-operative appointments.
  
  
  RESULTS
  Twenty-three patients (53 %) responded to our telephone survey after repeated attempts at contact. Median follow-up was 64 months (range 6–83 months). Of these patients, 19 (82.6 %) reported pre-operative headaches,compared to 12 (52.2 %) who reported post-operative headaches (OR = 1.75, p = 0.02). Average headache severity on a 1–10 scale decreased from 6.4 (SD = 2.0)pre-operatively to 3.4 (SD = 1.9) post-operatively (p = 0.006), while average maximum severity decreased from 8.6 (SD = 2.2) pre-operatively to 4.0 (SD = 3.3)post-operatively (p<0.001). The frequency of headaches also decreased, from 18.1 (SD = 12.6) per month pre-operatively to 3.7 (SD = 8.4) per month post-operatively(p<0.001). Overall, 14 patients (60.9 %) reported improvement in their headaches, and three patients(13.0 %) reported that their headaches had completely resolved.
  
  
  CONCLUSIONS
  In a carefully selected patient population,transsphenoidal surgery for RCC can reduce headache monthly frequency, average typical severity, and average maximum severity with minimal risk of morbidity or mortality.
authors.forename: David J
authors.initials: DJ
authors.lastname: Cote
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Besasie
authors.forename: M Maher
authors.initials: MM
authors.lastname: Hulou
authors.forename: Sandra C
authors.initials: SC
authors.lastname: Yan
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Smith
authors.forename: Edward R
authors.initials: ER
authors.lastname: Laws
mesh_terms: D000293:Adolescent; D000328:Adult; D020863:Central Nervous System Cysts / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006261:Headache / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D010911:Pituitary Neoplasms / Q000503:physiopathology / Q000601:surgery; D055815:Young Adult