Headache Associated With Pituitary Adenomas

Abe, Takumi; Matsumoto, Kiyoshi; Kuwazawa, Jiro; Toyoda, Izumi; Sasaki, Ken

doi:10.1046/j.1526-4610.1998.3810782.x

Cited by 109 publications

(132 citation statements)

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“…The widespread availability of advanced neuroradiological instruments has increased the chances of detecting patients with both pituitary adenoma and headaches. Headache is one of the major symptoms of pituitary adenoma, with a prevalence of 33-72%, although neurosurgeons occasionally cannot decide whether the pituitary adenoma causes the headache [4,5]. If the conventional medical treatment (multiple regimens, such as non-steroidal anti-inflammatory drugs, triptans, and antidepressant) proves ineffective, it would be necessary to make final decisions on whether to operate for the pituitary adenoma [6,7].…”

Section: Introductionmentioning

confidence: 99%

Significant improvement of intractable headache after transsphenoidal surgery in patients with pituitary adenomas; preoperative neuroradiological evaluation and intraoperative intrasellar pressure measurement

et al. 2015

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4Results. All nine patients had complete or substantial resolution of their formerly intractable headache after TSS. Headaches consisted of ocular pain ipsilateral to the adenoma localization within the sella in four cases and bifrontal headache in five.Magnetic resonance imaging of these patients revealed small diaphragmatic foramen, which were so narrow that only the pituitary stalk could pass. Computed tomography scans showed ossification beneath the sellar floor in the sphenoid sinus, presellar type in six cases, and choncal type in three. The adenomas included cysts in seven cases.There was no cavernous sinus invasion. Intrasellar pressure measurements averaged 41.5 ± 8.5 mmHg, range 34-59, significantly higher than in control patients without headache (n = 12), namely 22.2 ± 10.6 mmHg (16-30).Conclusion. In this study, the authors demonstrated the validity of TSS in the treatment of intractable headache associated with pituitary adenoma. The presence of ocular pain, especially ipsilateral to the adenoma, integrity of the diaphragm sella, and ossification in the sphenoid sinus, cyst or hemorrhage and the absence of cavernous sinus invasion were the indications for TSS for patients complaining of intractable headache and having pituitary adenomas. 5

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Section: Introductionmentioning

confidence: 99%

Significant improvement of intractable headache after transsphenoidal surgery in patients with pituitary adenomas; preoperative neuroradiological evaluation and intraoperative intrasellar pressure measurement

et al. 2015

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“…Some studies have suggested that the incidence of headache was 57.1% in non-functioning adenomas [7] and 60% in GH-secreting adenomas [8]. Headache seems to be more frequent in prolactin (PRL)-secreting adenomas (57.1%) than in GHsecreting adenomas (12.5%) [9]. Headache, more frequently localised to the frontal region, is bilateral (89.5%) or monolateral (84.2%) and sometimes diffuse (42.1%).…”

Section: Introductionmentioning

confidence: 99%

“…Pain is continuous or pressing-heavy, and rarely pulsating-intermittent (mostly in female patients) (57.9%) [9]. Headaches due to GH-secreting adenomas, with or without acromegaly, do not have significant sellar abnormalities or visual problems [5,8].…”

Section: Introductionmentioning

confidence: 99%

“…Headache seems to be more frequent in prolactin (PRL)-secreting adenomas (57.1%) than in GHsecreting adenomas (12.5%) [9]. Headache, more frequently localised to the frontal region, is bilateral (89.5%) or monolateral (84.2%) and sometimes diffuse (42.1%).Pain is continuous or pressing-heavy, and rarely pulsating-intermittent (mostly in female patients) (57.9%) [9]. Headaches due to GH-secreting adenomas, with or without acromegaly, do not have significant sellar abnormalities or visual problems [5,8].…”

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A case of a GH–producing pituitary adenoma associated with a unilateral headache with autonomic signs

et al. 2005

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IntroductionTen to fifteen percent of all diagnosed cerebral tumours are pituitary adenomas (60%-70% are secreting adenomas) that frequently occur during the 3rd or 4th decades of life. Half of them are diagnosed early by clinical hormonal symptoms even when the dimensions of the adenomas are small (5 mm) and the tumours are undetected on magnetic resonance imaging (MRI) scans. Among these, however, growth hormone (GH)-producing macroadenomas are uncommon, and often have blood hormonal levels so low that their diagnosis could be delayed [1,2]. In 10% of the adult population, MRI scans can detect silent pituitary adenomas [3].Thirty-three to seventy-two percent of pituitary adenomas, independently of their dimensions, induce headache [4,5]. Headache is the first symptom in about 11% of women and in about 15% of men [6]. Some studies have suggested that the incidence of headache was 57.1% in non-functioning adenomas [7] and 60% in GH-secreting adenomas [8]. Headache seems to be more frequent in prolactin (PRL)-secreting adenomas (57.1%) than in GHsecreting adenomas (12.5%) [9]. Headache, more frequently localised to the frontal region, is bilateral (89.5%) or monolateral (84.2%) and sometimes diffuse (42.1%).Pain is continuous or pressing-heavy, and rarely pulsating-intermittent (mostly in female patients) (57.9%) [9]. Headaches due to GH-secreting adenomas, with or without acromegaly, do not have significant sellar abnormalities or visual problems [5,8]. another MRI scan of the sellar region confirmed the presence of a pituitary macroadenoma on the left paramedian side. After an initial improvement of the symptomatology due to trans-sphenoidal ablation of a benign GH-producing macroadenoma, the headache worsened again. Pain was well correlated with the increased plasma levels of IGF-1. The patient died suddenly for myocardial infarct.

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“…Also, there was no clear relationship between the pituitary volume and headache score. 8,9 Many patients report headaches after starting pharmacotherapy for adenoma; one explanation given for why headaches get worse after taking dopamine agonist is that the growth of the tumor is transitory or that a neurohormonal mechanism is possible. 10,11 The degree of extension into the cavernous sinus is not associated with the presence or extent of headache.…”

Section: Discussionmentioning

confidence: 99%