The Association of Pituitary Tumors and Headache

Levy, Miles

doi:10.1007/s11910-010-0166-7

Cited by 42 publications

(40 citation statements)

References 47 publications

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“…29 It is also known that dopamine agonist therapy may improve migraine as well as markedly exacerbate headache in treatment of prolactinomas. 24 We found no hormone related variables that were associated with headache either before the diagnosis or at follow-up. However, hormone deficiencies were classified based on the interpretation of laboratory tests stated in the medical records and not assessed systematically or prospectively.…”

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confidence: 56%

“…3 Headache is a common cause for undergoing diagnostic cerebral MRIs that may lead to the incidental discovery of pituitary adenomas. 24 A recent retrospective study found that 24% of patients with pituitary tumours had headache as their chief complaint before surgery. 25 In the present study 12% of our patients had headache as the main symptom leading to the diagnostic MRI, presumably contributing to the higher prevalence of headache than in the general population at diagnose.…”

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confidence: 99%

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Pituitary Adenoma and Non-acute Headache: Is There an Association, and Does Treatment Help?

et al. 2016

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This work is based on a master thesis in applied clinical science at The Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. The content is concealed until 2018. Sources of financial and material support:The expenses were covered by the Norwegian Advisory Unit on Headache Gravdahl Abstract:Objective: Headache is a controversial indication for treatment of pituitary adenoma. We sought to study the possible relationship between pituitary adenomas and headache along with the symptomatic effects of treatment.Methods: 201 patients with pituitary adenoma underwent structured telephone interviews addressing current and prior headache complaints. Clinical variables and headache history were retrieved from medical records. Headache prevalence among patients was compared to a regional population-based cohort.Results: Headache suffering prior to the pituitary adenoma diagnosis was higher than in the general population (p<0.001). At follow-up, overall prevalence was lower (p<0.001), but chronic headache was more prevalent (p= 0.001) than in the general population. With the exception of family history, no associations between headache and clinical or radiological variables were identified. 77% of headache sufferers reported improvement and5 % reported worsening while 11 % reported new headaches at follow-up. Operated patients with non-functional adenoma more often reported improvement (85%) than non-operated patients (58%) (p=0.042). Conclusion:In a cohort with both treated and untreated patients with pituitary adenoma headache prevalence is low compared to the general population. We found no link between clinical or radiological variables and headache. Even though a higher proportion of operated patients report symptomatic relief, the majority of non-treated patients also improved. We believe that the rather unpredictable dynamics of headache over time and the lack of predictive and modifiable tumor related variables associated with headache or relief we believe this weakens headache as a sole indication for pituitary adenoma treatment.

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confidence: 99%

Pituitary Adenoma and Non-acute Headache: Is There an Association, and Does Treatment Help?

et al. 2016

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“…Mechanical, biochemical, vascular and biopsychosocial aspects, and also a genetic predisposition for primary headache might be involved in the pathogenesis of headache in pituitary disease (1). Among functional pituitary tumours, growth hormone (GH)-secreting adenomas and prolactinomas have been specifically associated with headache, possibly mediated by the change in endocrine status rather than the pituitary mass per se (2). Transsphenoidal surgery may lead to significant improvement in headache in patients with non-secreting and hypersecretory pituitary microadenomas (3).…”

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confidence: 99%

Clinical characteristics of pain in patients with pituitary adenomas

Dimopoulou

Athanasoulia

Hanisch

et al. 2014

European Journal of Endocrinology

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Objective: Clinical presentation of pituitary adenomas frequently involves pain, particularly headache, due to structural and functional properties of the tumour. Our aim was to investigate the clinical characteristics of pain in a large cohort of patients with pituitary disease. Design: In a cross-sectional study, we assessed 278 patients with pituitary disease (nZ81 acromegaly; nZ45 Cushing's disease; nZ92 prolactinoma; nZ60 non-functioning pituitary adenoma). Methods: Pain was studied using validated questionnaires to screen for nociceptive vs neuropathic pain components (painDETECT), determine pain severity, quality, duration and location (German pain questionnaire) and to assess the impact of pain on disability (migraine disability assessment, MIDAS) and quality of life (QoL). Results: We recorded a high prevalence of bodily pain (nZ180, 65%) and headache (nZ178, 64%); adrenocorticotropic adenomas were most frequently associated with pain (nZ34, 76%). Headache was equally frequent in patients with macroand microadenomas (68 vs 60%; PZ0.266). According to painDETECT, the majority of the patients had a nociceptive pain component (nZ193, 80%). Despite high prevalence of headache, 72% reported little or no headache-related disability (MIDAS). Modifiable factors including tumour size, genetic predisposition, previous surgery, irradiation or medical therapy did not have significant impact neither on neuropathic pain components (painDETECT) nor on headache-related disability (MIDAS). Neuropathic pain and pain-related disability correlated significantly with depression and impaired QoL.Conclusions: Pain appears to be a frequent problem in pituitary disease. The data suggest that pain should be integrated in the diagnostic and therapeutic work-up of patients with pituitary disease in order to treat them appropriately and improve their QoL.

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“…Dislalia was found in 1 patient, right palpebral ptosis in 1 patient, and headache in 41 patients (26.28%); the relationship between headache and IV-E stage of H-V classification was significant (p < 0.017). This relationship disappeared within 6 months in 30 of the patients after neurosurgery [16]. A tumor extension to the III ventricle was observed in 16 cases (10.26%), diabetes insipidus in 4 patients (2.56%), and pituitary apoplexy in 11 cases (7.05%).…”

Section: Resultsmentioning

confidence: 94%

Clinical and Neurological Manifestations of Non-Functioning Pituitary Adenomas (NFPA). Is it ok to Suspect an Early Invasiveness?

Sánchez-Turcios¹,

Rangel-Morales²,

Fj³

2015

EMIJ

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Introduction: Clinically non-functioning pituitary adenomas (NFPA) are a heterogeneous set of complex adenomas with a wide variety of immunohistochemical subtypes such as silent gonadotrope, null cell adenoma, silent corticotrope adenoma, and other silent tumors of somatotrope, thyrotrope, and lactotrope lineages. The diagnosis is established by hypothalamus-pituitary MRI, which gives the volume of the tumor, and by determining the pituitary hormones, peripheral hormones when indicated, and neurologic manifestations. In NPFA, there is neither a typical hormonal hyper secretion nor a determined clinical syndrome.

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The Association of Pituitary Tumors and Headache

Cited by 42 publications

References 47 publications

Pituitary Adenoma and Non-acute Headache: Is There an Association, and Does Treatment Help?

Pituitary Adenoma and Non-acute Headache: Is There an Association, and Does Treatment Help?

Clinical characteristics of pain in patients with pituitary adenomas

Clinical and Neurological Manifestations of Non-Functioning Pituitary Adenomas (NFPA). Is it ok to Suspect an Early Invasiveness?

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