Headache After Resection of Acoustic Neuroma
Article first published online: 17 JUN 2002
Headache: The Journal of Head and Face Pain
Volume 39, Issue 2, pages 89–94, February 1999
How to Cite
Mosek, A. C., Dodick, D. W., Ebersold, M. J. and Swanson, J. W. (1999), Headache After Resection of Acoustic Neuroma. Headache: The Journal of Head and Face Pain, 39: 89–94. doi: 10.1046/j.1526-4610.1999.3902089.x
- Issue published online: 17 JUN 2002
- Article first published online: 17 JUN 2002
- Accepted for publication June 11, 1998.
- acoustic neuroma;
- suboccipital approach;
- translabyrinthine approach
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 surgica1 approaches for acoustic neuroma resection is reviewed, and possible explanations for development of the pain are discussed.