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Significant improvement in chronic persistent headaches caused by small Rathke cleft cysts after transsphenoidal surgery
Abstract Purpose Rathke cleft cysts (RCC) are usually asymptomatic and can be observed using conservative methods. However, some patients with RCCs have severe headaches even if they are small enough to be confined to the sella, and these small RCCs have seldom been discussed. This study presents an...
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Published in: | World neurosurgery 2017-03, Vol.99, p.362-368 |
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Main Authors: | , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | Abstract Purpose Rathke cleft cysts (RCC) are usually asymptomatic and can be observed using conservative methods. However, some patients with RCCs have severe headaches even if they are small enough to be confined to the sella, and these small RCCs have seldom been discussed. This study presents an investigation into clinical characteristics of small RCCs associated with severe headaches, demonstrating efficacy and safety of endoscopic transsphenoidal surgery (ETSS) to relieve headaches. Methods In this study, 13 patients with small RCCs (maximum diameter < 10mm) who presented with headaches and were treated by ETSS at our institute from 2009 to 2014 were recruited. These RCCs were treated Headache impact test (HIT)-6 score was calculated both pre- and postoperatively to evaluate headache severity. Results All patients complained of severe headaches, which disturbed their daily life. Most headaches were non-pulsating and localized in the frontal area. Characteristically, 6 patients (46%) experienced severe headaches with sudden onset while continued chronically. HIT-6 score was 64 on average, meaning headaches affected daily life severrely. After surgical decompression of the cyst, headache in all of the patients improved dramatically and HIT-6 score decreased significantly to 37, suggesting that headaches were diminished. No newly developed deficiencies of the anterior pituitary lobe function were detected. Postoperative occurrence of diabetes insipidus was found in 2 patients, both of which were transient. No recurring cysts were found. Conclusion Severe headaches can develop from small RCCs. In the present study, ETSS was performed on such patients effectively and safely to relieve their headaches. |
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ISSN: | 1878-8750 1878-8769 |
DOI: | 10.1016/j.wneu.2016.12.111 |