Treatment of Severe Trigeminal Headache in Patients With Pituitary Adenomas

Freitas, Tiago da Silva; Ferreira, Ivan Coelho; Neto, Aldo Pereira; Neto, Oswaldo Ribeiro Marquez; Gomes, Gustavo do Vale; Mota, Luis Augusto Casulari Roxo da; Naves, Luciana Ansaneli; Azevedo, Monalisa F.

doi:10.1227/neu.0b013e31820c6c9e

Cited by 3 publications

(1 citation statement)

References 33 publications

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“…Headache was assessed by the Headache Impact Test version-6 (HIT-6), which was produced by the Shun-ichi Fukuhara and Glaxo Smith Kline Group of companies, and was administered by one of the authors [9,10]. This test can evaluate the impact of patients' headaches on their social activities.…”

Section: Headache Evaluationmentioning

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: Headache Evaluationmentioning

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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Contribution of Intrasellar Pressure Elevation to Headache Manifestation in Pituitary Adenoma Evaluated With Intraoperative Pressure Measurement

et al. 2018

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Clinical and laboratorial characterization and post-surgical follow-up of 87 patients with non-functioning pituitary macroadenomas

Mello

Naves

Neto

et al. 2013

Arq. Neuro-Psiquiatr.

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Objective:It was to assess the main characteristics of patients undergoing pituitary tumor surgery.Method:Eighty-seven patients (44 men; 44.8±13 years old) were included.Results:The main symptoms were visual alterations (87.3%), headache (70.1%), diminished libido (34.4%), galactorrhea (22.9%) and hair loss (19.5%). The axes affected were gonadotropic (72.6%), thyrotropic (48.4%) and corticotropic (38.7%), without significant changes after surgery. The average largest tumor diameter was 3.1 cm before surgery and 1.56 cm after surgery. The most frequent postoperative complications were hydro-electrolyte and acid-base disorders (12%), diabetes insipidus (9%), visual field alterations (9%), liquoric fistula (8%) and nasal obstruction (7%). The patients were affected by more than one complication.Conclusion:Although a decrease in tumor volume was achieved through surgery, hormonal deficiencies persisted in most of the patients and new surgical approaches were necessary for dealing with tumor recurrence or persistence.

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Treatment of Severe Trigeminal Headache in Patients With Pituitary Adenomas

Abstract: Percutaneous ganglion blockade and trigeminal rhizotomy may be promising alternative options for the treatment of severe headache in selected patients with pituitary adenomas.

Cited by 3 publications

References 33 publications

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

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

Contribution of Intrasellar Pressure Elevation to Headache Manifestation in Pituitary Adenoma Evaluated With Intraoperative Pressure Measurement

Clinical and laboratorial characterization and post-surgical follow-up of 87 patients with non-functioning pituitary macroadenomas

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