(840) Elucidating Headache Burden After Vestibular Schwannoma Resection: A Cross-sectional Survey Analysis

Introduction: Surgical resection of vestibular schwannomas (VSs) can be associated with postoperative headaches, but the true quality of life impact of these headaches is poorly defined. This study seeks to assess this impact through a cross-sectional online survey.

Methods: A survey was developed to assess headache-related outcomes. It has been hosted by the Acoustic Neuroma Association from August 2025 to January 2026, where any adult with a history of surgical resection for VS was invited to participate. Descriptive statistics and chi-square analyses were performed to evaluate these results.

Results: Thirty-two participants have completed the survey to date, with 26 (81.3%) identifying as female and 20 (62.5%) being > 50 years old at the time of surgery. Before surgery, 15 individuals (46.9%) had a history of recurrent headaches, with 9 patients (28.1%) reporting a specific history of migraines. Postoperatively, out of the overall cohort, 20 (62.5%) reported new or worsening headaches, with 9 (28.1%) specifically experiencing daily headaches. Twenty patients (62.5%) have seen a medical provider, including neurologists, primary care physicians, and chiropractors, for their headaches since surgery, with 11 (34.4%) having more than ten visits. Eight participants (25.0%) report spending at least $100 monthly on headache medications. Amongst the cohort, 18 (56.3%) and 10 (31.3%) patients underwent a retrosigmoid (RS) and translabyrinthine (TL) approach, respectively. Between these participants, RS patients reported worsened productivity at work or school (13 RS vs. 5 TL, p=0.044) and limitations in their physical activities (14 RS vs. 5 TL, p=0.038), but no other significant differences were noted, including new or worsening headaches.

Conclusions: Headaches following VS resection are associated with significant financial burden and healthcare utilization. The RS approach may be associated with greater functional impairment, but future studies are needed to further elucidate these findings.