Headache as an indication for surgery in non-functioning pituitary adenoma and Rathke's cleft cyst: A systematic review
Abstract
PURPOSE: Headaches are a common presentation in clinical practice, often necessitating further evaluation and management. This study aims to comprehensively analyze available literature regarding headaches as an absolute surgical indication for patients with nonfunctioning pituitary adenomas (NFPAs) and Rathke's cleft cysts (RCCs), shedding light on postoperative headache resolution, and surgical complications.
METHOD: Following PRISMA guidelines, PubMed, Scopus, Embase, and Web of Science were searched until October 10th, 2023, using specified keywords. Inclusion criteria involved studies describing patients with NFPA or RCC, where headache was the sole surgical indication. Data were extracted, and quality assessed using the Joanna Briggs Institute (JBI) checklist.
RESULTS: A total of 13 studies met the inclusion criteria, comprising 183 individuals who underwent surgical intervention for headaches caused by NFPA (n = 111) or RCC (n = 75). The majority of patients experienced headache improvement (75.8 %), while persistent headaches were noted in 19.8 %, and worsening in 4.3 %. Headache recurrence was infrequent (7.1 %), and postoperative complications including transient diabetes insipidus (29.4 %), cerebrospinal fluid leak (17.6 %), postoperative infection (17.6 %), and adrenal insufficiency (17.6 %) were reported. Quality assessment using JBI checklists indicated variable risk of bias across studies.
CONCLUSION: Surgical interventions significantly improved headache…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 183 participants or records.
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