Headache Frequent After Acoustic Neuroma Surgery

A new study has found that headache is twice as common after acoustic neuroma surgery than before, and the new onset headache appears to typically have certain common characteristics.

Researchers at the University of Helsinki (Finland) examined survey responses from 192 patients who had undergone acoustic neuroma surgery. In all, 61 (32%) reported headache preoperatively, of which 47 patients reported migraine and nine did so for tension-type headache. After the operation, 122 patients (64%) reported headache. This included 15 respondents with new migraine and four with new tension-type headache. In 86% of the patients, the postoperative headache was chronic, lasting at least three months. At the time of the survey, the headache persisted in 55%, and typically presented in severe short attacks, provoked by physical stress, bending, or coughing. Treatment with non-steroidal anti-inflammatory drugs was usually effective. The study was published in the October 2007 issue of Cephalalgia.

"Headache after acoustic neuroma operation is relatively common, and variations in neurosurgical techniques have not solved the problem completely,” said lead author Dr. Tuomas Rimaaja, D.D.S. "Surgical treatment of acoustic neuroma means major skull base surgery to patients experiencing only minimal preoperative symptoms, and may lead to major postoperative symptoms. Patients need to be well informed about possible outcomes after surgery.”

An acoustic neuroma is a benign primary intracranial tumor of the myelin-forming cells of the vestibulocochlear (VIII) nerve. The correct medical term is actually vestibular schwannoma, since it involves the vestibular portion of the 8th cranial nerve and it arises from Schwann cells, which are responsible for the myelin sheath in the peripheral nervous system. The prevalence of the neuroma is 1:100,000 worldwide. Incidence peaks in the fifth and sixth decades and both sexes are affected equally.


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