Postoperative headache following treatment of vestibular schwannoma: A literature review

Vestibular schwannoma (VS) is a brain tumour arising from Schwann cells that is typically closely associated with the vestibulocochlear nerve. Post-operative headaches (POH) are a potentially common complication of surgery for VS. Greatly differing rates of POH have previously been reported, particularly with different surgical approaches. The aim of this review is to identify and summarise the available peer-reviewed evidence on rates of POH following operative (or radiosurgery) treatment for VS, in addition to information about the treatment and prognosis of POH in these patients. A systematic search was conducted of Pubmed, Medline, Scopus and EMBASE in April 2017 using the medical subject headings (acoustic neuroma OR vestibular schwannoma) AND headache. Eligibility determination and data extraction were performed in duplicate with standardised forms. POH is common following surgery for VS. Differing rates of POH have been reported with different management approaches, patient age and tumour size. There are relatively few studies that have directly compared the rates of POH with different surgical approaches. The retrosigmoid approach with craniotomy appears to have lower rates of POH than when the retrosigmoid approach is performed with craniectomy. Patients under the age of 65 and with tumours <1.5 cm in size appear to have a higher risk of POH. The most commonly documented management of POH involves simple analgesia, although the majority of patients report this treatment is of only minimal benefit. Further prospective studies comparing rates of POH following different surgical approaches and radiosurgery are required.