title: Presence of headache and headache types in patients with tumors of the sellar region-can surgery solve the problem? Results of a prospective single center study.
abstract: OBJECTIVE
  Headache is a common presenting feature of patients with pituitary adenomas and other tumors of the sellar region. However, at present, it still is unclear whether the headache is actually caused by the tumor. To explore whether there is a relation, we examined in detail the headache types, their relationship to the underlying pathology, and if the headache responded to neurosurgery in a prospective study design.
  
  
  METHODS
  One hundred twelve patients with tumors of the sellar region scheduled for neurosurgery in a single center were analyzed for presence and quality of headache before surgery and at least 3 months after surgery. Patients received headache and depression self-rating inventories, presented on a handheld computer (PainDetect®). Clinical variables thought to impact on headache were analyzed in conjunction with the inventories.
  
  
  RESULTS
  Fifty-nine (53%) patients reported headache in the 3 months prior to neurosurgery, 49 (44%) had headache at the time of filling in the questionnaires. The four patients with pituitary apoplexy described thunderclap headache. In the other patients diverse headache types were encountered, most frequently migraine. Untreated gonadotroph deficiency was significantly associated with absence of headache, while none of the other clinical and morphological variables related to headache. Presence of headache and disability due to headache were not significantly reduced after surgery.
  
  
  CONCLUSIONS
  Apart from pituitary apoplexy we detected no specific headache type in our patient group and no significant improvement of headache after neurosurgery. Headache alone constitutes neither a valid diagnostic marker for the presence of tumors of the sellar region nor a sufficient indication for tumor removal.
authors.affiliation: Department of Neurosurgery, University of Duisburg-Essen, Hufelandstr. 55, Essen, 45147, Germany.
authors.forename: Sonja
authors.initials: S
authors.lastname: Siegel
authors.affiliation: Siemens Healthcare GmbH, Henkestr, 127, Erlangen, 91052, Germany.
authors.forename: Renata
authors.initials: R
authors.lastname: Weber Carneiro
authors.affiliation: Department of Neurosurgery, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Schwabachanlage 6, Erlangen, 91031, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Buchfelder
authors.affiliation: Department of Neurosurgery, University of Duisburg-Essen, Hufelandstr. 55, Essen, 45147, Germany.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Kleist
authors.affiliation: Department of Neurosurgery, University of Duisburg-Essen, Hufelandstr. 55, Essen, 45147, Germany.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Grzywotz
authors.affiliation: Institute of Neuropathology, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Schwabachanlage 6, Erlangen, 91031, Germany.
authors.forename: Rolf
authors.initials: R
authors.lastname: Buslei
authors.affiliation: Department of Neurology, University of Duisburg-Essen, Hufelandstr. 55, Essen, 45147, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Bingel
authors.affiliation: Department of Internal Medicine I, University of Luebeck, Ratzeburger Allee 160, Luebeck, 23538, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Brabant
authors.affiliation: Department of Psychology, Ludwig-Maximilians University Munich, Leopoldstr. 13, Munich, 80802, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Schenk
authors.affiliation: Department of Neurosurgery, University of Duisburg-Essen, Hufelandstr. 55, Essen, 45147, Germany. Ilonka.kreitschmann@uk-essen.de.
authors.forename: Ilonka
authors.identifier: http://orcid.org/0000-0002-6389-0261
authors.initials: I
authors.lastname: Kreitschmann-Andermahr
mesh_terms: D000236:Adenoma / Q000150:complications / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006261:Headache / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D019635:Neurosurgical Procedures / Q000379:methods*; D010911:Pituitary Neoplasms / Q000150:complications / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Headache; Neurosurgery; Pituitary adenoma; Sellar region