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Vol. 31. Issue 6.
Pages 261-267 (November - December 2020)
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Vol. 31. Issue 6.
Pages 261-267 (November - December 2020)
Clinical research
Postcraniectomy pain: Comparison between 2 incisions for the retrosigmoid approach. Prospective randomized study
Dolor poscraniectomía: comparación entre 2 incisiones para el abordaje retrosigmoideo. Estudio prospectivo aleatorizado
Emiliano Loreficea,
Corresponding author

Corresponding author.
, Francisco Marcó del Ponta, Sebastián J.M. Giovanninia, Sol Cavanaghb, María Teresa Goicocheab, Andrés Cervioa
a Departamento de Neurocirugía, FLENI, Buenos Aires, Argentina
b Departamento de Neurología, Clínica de cefalea, FLENI, Buenos Aires, Argentina
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Tables (2)
Table 1. SF-36 questionnaire items.
Table 2. Postoperative complications in the two groups.
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Suboccipital lateral approach is a common practice in neurosurgery to expose the region of the cerebellopontine angle. Postcraniectomy headache (PCH) is one of the most frequent complications that diminish the quality of life of patients.


To compare postcraniectomy pain in patients operated on for vestibular neurinomas by a suboccipital lateral approach by 2 different incisions.

Material and methods

Prospective randomised research study. Follow-up of patients operated for vestibular neurinomas between July 2017 and May 2019 (n=40) by the same surgeon. One group received the classical linear incision (n=20) and another group the alternative incision in an inverted “U” (modified Dandy) (n=20). Pain intensity was evaluated by numerical scale. A minimum follow-up of 3 months was carried out. The impact on quality of life was measured by the SF-36 questionnaire short version both before and after surgery.


The average age was 46.1 years. The overall PCH index was 27.5% (n=11) of the patients. The incidence of pain in the group that received the classical incision (A) was 20% (n=4) and in group B was 35% (n=7).


We found a higher rate of post-craniectomy headache in patients who underwent a “modified Dandy” incision. These are preliminary data of an undergoing study and we hope to obtain more representative information in the future. We recommend interdisciplinary follow up for the integral treatment of PCH.

Postoperative pain

El abordaje suboccipital lateral es de práctica habitual en neurocirugía para exponer la región del ángulo pontocerebeloso. El dolor poscraniectomía (DPC) es una de las complicaciones más frecuentes que disminuyen la calidad de vida de los pacientes.


Comparar el DPC en pacientes operados de neurinomas vestibulares por un abordaje suboccipital lateral mediante 2 incisiones distintas.

Material y métodos

Estudio de investigación prospectivo aleatorizado. Se realizó seguimiento de un grupo de pacientes operados por neurinomas vestibulares entre julio de 2017 y mayo de 2019 (n=40) por un mismo cirujano. Un grupo recibió la incisión lineal clásica (n=20) y otro grupo la incisión alternativa en «U» invertida o «Dandy modificada» (n=20). La intensidad del dolor fue evaluada mediante escala numérica. Se realizó un seguimiento mínimo de 3 meses. El impacto en la calidad de vida se objetivó mediante cuestionario SF-36 versión corta tanto pre- como posquirúrgico.


La edad promedio fue 46,1 años. El índice global de DPC fue del 27,5% (n=11) de los pacientes. La incidencia de cefalea en el grupo que recibió la incisión clásica (A) fue del 20% (n=4), en el grupo B fue del 35% (n=7).


Encontramos un mayor índice de DPC en los pacientes que recibieron una incisión tipo «Dandy modificada». Estos son datos preliminares de un estudio que continúa y esperamos obtener datos más representativos en el futuro. Recomendamos el seguimiento interdisciplinario para el tratamiento integral del DPC.

Palabras clave:
Dolor poscraniectomía


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