Complications are uncommon in any of the modern approaches, but there is a generally recognised morbidity and mortality associated with them. The trans-frontal operations are associated with higher levels of morbidity and mortality as compared to the trans-sphenoidal approach.
There is a greater tendency to re-operate for suspected haematoma in the transcranial approach.
The transfrontal approach is also associated with a 3-4% risk of epilepsy. A patient undergoing a transfrontal approach is barred from driving for a year due to the epilepsy risk. The trans-sphenoidal approach carries no evident risk of epilepsy.
The risk of CSF leakage is higher in patients undergoing the trans-sphenoidal approach than in other approaches.