TY - JOUR
T1 - Headache after resection of acoustic neuroma
AU - Mosek, Amnon C.
AU - Dodick, David W.
AU - Ebersold, Michael J.
AU - Swanson, Jerry W.
PY - 1999
Y1 - 1999
N2 - 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 postoperative 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.
AB - 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 postoperative 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.
KW - Acoustic neuroma
KW - Headache
KW - Suboccipital approach
KW - Translabyrinthine approach
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U2 - 10.1046/j.1526-4610.1999.3902089.x
DO - 10.1046/j.1526-4610.1999.3902089.x
M3 - Article
C2 - 15613200
AN - SCOPUS:0033056664
SN - 0017-8748
VL - 39
SP - 89
EP - 94
JO - Headache
JF - Headache
IS - 2
ER -