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The occurrence of neuropathic pain following surgery of brainstem cavernous malformations
Author(s) -
Herten Annika,
Saban Dino,
Santos Alejandro N.,
Chen Bixia,
Darkwah Oppong Marvin,
Rauschenbach Laurèl,
Jabbarli Ramazan,
Wrede Karsten,
Bingel Ulrike,
Müller Daniel,
HolleLee Dagny,
Schmidt Börge,
Li Yan,
Sure Ulrich,
Dammann Philipp
Publication year - 2022
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.15179
Subject(s) - medicine , neuropathic pain , quality of life (healthcare) , visual analogue scale , brainstem , clinical significance , anesthesia , physical therapy , surgery , nursing
Background and purpose This study aimed to assess the occurrence and significance of postoperative neuropathic pain (NP) in patients with surgically treated brainstem cavernous malformations (BSCMs). Methods Seventy‐four BSCM patients surgically treated between 2003 and 2019 were reviewed for the occurrence of postoperative NP and related treatment. The relevance of BSCM location, preoperative characteristics, influence on functional outcome, postoperative health‐related quality of life (HRQOL) and life satisfaction was evaluated. Results Six out of 74 patients (8%) suffered from NP. The Leeds Assessment of Neuropathic Symptoms and Signs scores ranged from 12 to 16 (mean 14.28 ± 1.6). Visual analog scale pain was 5.2 ± 2.0. NP had no effect on preoperative characteristics or functional outcome. Bodily pain (HRQOL) and vocational time (life satisfaction) were significantly decreased in NP compared to non‐NP patients. Specific BSCM location (regarding brainstem nuclei involved in pain processing) and other preoperative patient‐ and BSCM‐related parameters were not associated with the occurrence of postoperative NP. Three out of six patients were currently under NP‐specific treatment. The proportion of patients suffering from postoperative NP (8%) was substantially higher compared to previously published studies. The pain affected the HRQOL of patients, most of whom were insufficiently treated and not satisfied with treatment results. Conclusion Our findings may help to raise awareness for postoperative NP in BSCM, which is essential to improve diagnosis and initiation of proper treatment, as well as preoperative informed consent of patients.