Resolution of Migraine with Aura After Successful Treatment of A Pituitary Microadenoma

Gabrielli, Maurizio; Gasbarrini, Antonio; Fiore, Giuseppina; Padalino, C.; Martini, Demetrio De; Giacovazzo, M; Pola, Paolo

doi:10.1046/j.1468-2982.2002.00314.x

Cited by 16 publications

(19 citation statements)

References 8 publications

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“…The use of somatostatin analogs, such as octreotide, in acromegaly patients with associated headache is related to immediate analgesic effect in some of them [8, 22]. Similar phenomenon occurs with dopamine-agonists in patients with prolactinomas [23–25]. However, significant exacerbation of the headache has also been reported when these drugs are used [26].…”

Section: Discussionmentioning

confidence: 99%

Headache associated with pituitary tumors

et al. 2008

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The objective of this study is to analyze the presence of headache in pituitary tumors and their characteristics, the relationship between pituitary tumor size, biological type, local extension and intrasellar pressure (ISP). This is a prospective study, of 64 consecutive patients presenting with primary pituitary masses at Neuroendocrinological Department of General Hospital of Fortaleza from October 2005 to December 2006. We analyzed sex, age, headache (laterality, site, severity, quality, frequency, duration, associated symptoms, time of onset, trigger, alleviating factors and familial history) and tumor characteristics (type, size, quiasmatic compression, cavernous sinus invasion, sella turcica destruction, cystic or solid mass and ISP). We observed a statistic significant factor between pituitary tumor and tumor size, optic compression, sellar destruction, cavernous sinus invasion and ISP. Biochemical-neuroendocrine factors, mainly in prolactinomas, seem to be an important factor in the determination of headache. The presence of headache in pituitary tumor is related to a combination of factors, including ISP, tumor extension, relationship with the sellar structures, patient predisposition, familial history, and functional disturbance within the hypothalamo-pituitary axis.

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Section: Discussionmentioning

confidence: 99%

Headache associated with pituitary tumors

et al. 2008

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“…CLH was referred to be secondary to the subclavian steal phenomenon [19], and recently a case of migraine with aura was reported that resolved after treatment of a PRL-secreting pituitary microadenoma [20].…”

Section: Discussionmentioning

confidence: 99%

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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“…A full discussion of the clinical classification and pharmacotherapy of headache is outside the scope of this article. The most common headache syndrome observed in association with pituitary tumors is chronic migraine, often occurring in patients with previous migraine [4,[17][18][19]. There is an increased prevalence of trigeminal autonomic cephalgias (TACs) in patients with pituitary tumors compared with the general population [20•], which includes cluster headache [4,7,11,12], SUNCT (short-lasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing) [4,6,8,9], paroxysmal hemicrania [21], and hemicrania continua [6].…”

Section: Clinical Featuresmentioning

confidence: 99%

“…Microprolactinomas are most frequently seen in young women, the same group of patients most likely to have migraine, so the combination of migraine and prolactinoma is relatively common. Normalization of reproductive symptoms with dopamine agonist therapy alone may improve headache without the need for specific migraine prophylaxis [4,18].…”

Section: Prolactinomasmentioning

confidence: 99%

The Association of Pituitary Tumors and Headache

Levy

2010

Curr Neurol Neurosci Rep

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Pituitary tumors may give rise to headache via numerous mechanisms. The traditional explanation for headache is dural stretch and cavernous sinus invasion, although this is not borne out by clinical studies. Certain functional pituitary tumors are associated with headache, notably growth hormone and prolactin-secreting tumors. The observation that somatostatin analogues can have a dramatic analgesic effect in acromegaly suggests that biochemical properties of the tumor may be important. The genetic predisposition of the patient to primary headache also determines whether headache occurs with pituitary tumors. This article attempts to outline the clinical features, management strategies, and key academic questions regarding the subject of pituitary tumors and headache.

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Resolution of Migraine with Aura After Successful Treatment of A Pituitary Microadenoma

Cited by 16 publications

References 8 publications

Headache associated with pituitary tumors

Headache associated with pituitary tumors

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

The Association of Pituitary Tumors and Headache

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