LAUSR

BACKGROUND Patients with nonfunctioning pituitary macroadenomas commonly experience headaches before and after surgery, and headaches have been reported to significantly detract from the quality of life. Despite this adverse impact, few studies have examined the prevalence and pattern of headaches on a long-term basis. Thus, this study employed a longitudinal cohort design to identify headache prevalence and severity during a 6-month postoperative period and its predictors. METHODS Forty patients with nonfunctioning pituitary macroadenomas who underwent transsphenoidal surgery were enrolled as subjects, and Headache Impact Test-6 (HIT-6) was performed at four time points: before and 1, 3, and 6 months after surgery. RESULTS This study revealed that nonfunctioning pituitary macroadenoma patients suffered from headaches at each of the four time points and that 37.5%, 27.8%, 17.9%, and 12.8% of the patients experienced "substantial and severe impact headaches" before and 1, 3, and 6 months after surgery, respectively. In addition, total HIT-6 scores 1 month after surgery were a significant predictor (B = 0.41, p < 0.001) of headaches 3 and 6 months after surgery. Among the HIT-6 items, pain (B = 0.09, p < 0.001), cognitive function (B = 0.07, p < 0.001), and psychological distress (B = 0.07, p < 0.001) showed the greatest impact on long-term headaches. CONCLUSION Headaches adversely affected patients even 6 months after surgery. Additionally, headaches 1 month after surgery predicted the prevalence of long-term headaches at 3 and 6 months, demonstrating the importance of timely postsurgical measurement of headaches to anticipate patients' long-term headache patterns.