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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An unusually therapy-resistant form of Nelson's syndrome developed in a 23-year-old woman two years after treatment of a pituitary-dependent Cushing's syndrome by bilateral adrenalectomy (1977). Removal of a corticotrophic adenoma by a first transsphenoidal pituitary operation (1979) brought only temporary relief. Two years later, regrowth and apoplexy of the pituitary adenoma led to oculomotor paralysis and had to be treated by a second transsphenoidal operation (1981). A second relapse became manifest two years later. Treatment with bromocriptine relieved the headaches but did not diminish the tumor size. A third pituitary operation (1984) became necessary when neurological signs revealed penetration of the cavernous sinus. The tumor was only partly removed by transsphenoidal surgery. Postoperative deterioration of the patient required emergency craniotomy to check a subarachnoidal hemorrhage and for removal of the remaining tumor. The patient died three days later of pneumococcal meningitis which had developed after the third pituitary operation.
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PMID:[A fatal course of Nelson syndrome]. 323 90

We report a case of Rathke's cleft cyst in pituitary tumor. A 31-year-old woman admitted to our hospital complained of visual disturbance, headache, amenorrhea and galactorrhea. Serum prolactin level was 3,060 ng/ml. By means of CT scan and MRI, we found suprasellar-extending tumor to have cystic component in the center of the tumor. Transsphenoidal surgery revealed grayish jelly-like content in the cyst. Histologically tumor cells were composed of chromophobic, basophilic and eosinophilic cells. The cyst wall in the pituitary adenoma was composed of ciliated or non-ciliated columnar epithelium intermingled with goblet cells, being similar to Rathke's cleft cyst. Except for the cells of the cyst wall, most of the tumor cells were immunoreactive for prolactin. As for intermediate filament, tumor cells in both solid and cystic portions showed positive immunoreactivity for cytokeratin and GFAP, and not for vimentin and neurofilament. These results suggest that the nature of the intracytoplasmic filament in the pituitary tumor with Rathke's cleft cyst may be not only keratin but also GFAP.
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PMID:[A case of prolactinoma in close association with Rathke's cleft cyst]. 332 Aug 6

We studied two autopsy cases of primary pituitary carcinoma. Case-1. A 45 year old female was admitted on Oct. 4 1978, with a complaint of right homonymous hemianopsia. And diagnosis was pituitary adenoma. Partial removal of pituitary tumor was performed on Oct. 23 1978. She died on Dec. 5 1978 due to bleeding of gastrointestinal tract. Autopsy disclosed a pituitary carcinoma invading the left hypothalamus, mamillary body, optic and V cranial nerves, and mid brain as well as sphenoid bone. No extracranial metastasis was noted. Case-2. A 44 year old female with a history of acromegaly for 6 years was admitted with a complaint of headache on May 8 1976. She was diagnosed as having pituitary adenoma. The subtotal removal of pituitary tumor was performed on May 21 1976 and followed by 4500 rad irradiation. At this time, pathological diagnosis was eosinophilic adenoma. Seven years later, she complained of progressive right hearing disturbance, dysarthria and ataxic gait 1983. The second subtotal removal of pituitary tumor was performed with a diagnosis of recurrence of pituitary adenoma on Oct. 7 1983. After the operation, she complicated sepsis and died on Jan. 14 1984. An autopsy disclosed a pituitary carcinoma from residual pituitary gland, continuously extending to the subarachnoid space of the pons, and invading right cerebello-pontine angle and cerebellum. The histological examination revealed pituitary carcinoma with high pleomorphism and glioblastoma multiform-like feature were within the tumor.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Two autopsy cases of primary pituitary carcinoma]. 341 67

A patient with mild hyperprolactinemia and a CT-scanned 6 x 9 mm pituitary adenoma is described. Pregnancy occurred spontaneously. During pregnancy severe headache and rapidly increasing visual field defects due to suprasellar extension of the adenoma were observed. The patient was treated with bromocriptine in a dose of 5 mg daily which resulted in dramatic improvement of symptoms in 2 weeks and a normalization of the visual field within 3 weeks.
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PMID:Effective management of a suprasellar extending prolactinoma during pregnancy. 345 22

The present study was undertaken to investigate whether headache in women with nonpuerperal hyperprolactinemia was related to elevated serum prolactin (PRL) levels or the presence of a PRL-secreting pituitary adenoma. The subjects were 469 women seen initially during the period of 1973 to 1979 at four clinical centers with the complaints of secondary amenorrhea and/or galactorrhea, 212 of whom were subsequently diagnosed as having a prolactinoma. Headaches were four times more frequent (relative odds = 3.92; 95% confidence interval = 1.54 to 9.97) in the presence of an adenoma than in its absence. This effect was not altered by adjustment for PRL level or study center, nor could it be explained by confounding due to age, occupation, level of education, use of oral contraceptives, cigarette smoking, ethnic group, or history of head injury. Hyperprolactinemia was associated with headache only if a prolactinoma was present (chi 2 = 9.524; P = .002) and not in the absence of a prolactinoma (chi 2 = 1.547; P = .214). These findings suggest that the space-occupying mass effect of a prolactinoma is responsible for headache in women with nonpuerperal hyperprolactinemia. Despite its nonspecific nature, headache may be a useful indicator of the presence of an occult prolactinoma in women with secondary amenorrhea and/or galactorrhea.
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PMID:Headache, hyperprolactinemia, and prolactinomas. 373 35

A 34-year-old male with a pituitary adenoma was investigated and demonstrated to have hypersecretion of both gonadotrophins in the basal state. Immunocytochemical staining and electron microscopic examination were positive for tumour cells secreting FSH and LH. Presenting symptoms included visual disturbances, loss of libido, impotence, cold intolerance, frontal headaches, change in skin pigmentation and excessive weight gain. The patient denied alteration in hair distribution, had no acral features, galactorrhoea or gynaecomastia. Surgical extirpation resulted in complete amelioration of his symptoms over a three year follow-up period. Basal and stimulated pituitary function testing results returned to normal post-operatively. A review of the literature documents six other cases of pituitary tumour secreting both LH and FSH in the basal state. More commonly, the pituitary adenoma secretes FSH only. The literature is reviewed with regard to both types of tumour.
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PMID:Gonadotrophin-secreting pituitary tumour: report and review. 391 72

The association of pituitary adenoma and adjacent cerebral aneurysm is not uncommon and acute hemorrhage into a pituitary adenoma is also a well recognized condition. However, the simultaneous occurrence of pituitary apoplexy with intracranial aneurysm is very rare. Such a case demonstrates the diagnostic difficulty in distinguishing between pituitary apoplexy and rupture of an aneurysm. We reported a patient with subarachnoid hemorrhage in whom a hemorrhage into the pituitary adenoma and a carotid-ophthalmic aneurysm was proven, and discussed the differential diagnosis and treatment. A 41-year-old man, who developed sudden severe headache with nausea and vomiting, was admitted to our hospital. Examination disclosed a mildly stuporous man with bilateral defects of upper lateral visual fields and lumbar puncture revealed subarachnoid hemorrhage. Plain radiographs of the skull showed an enlarged and eroded sella turcica. Carotid angiography revealed a left carotid-ophthalmic aneurysm. A plain CT scan demonstrated an acute suprasellar hematoma. A transsphenoidal operation was performed and postoperative course was uneventful.
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PMID:[Pituitary apoplexy with an unruptured carotid-ophthalmic aneurysm]. 401 Aug 80

A 44-year-old man came to our clinic, complaining of slowly progressive disturbance of visual acuity and of ocular movement. This patient suffered from headache, narrowing of visual field and polyuria about 20 years ago, and received surgical and radiation therapy under the diagnosis of pituitary adenoma. Clinical symptoms and signs of this patient, except for bitemporal hemianopsia, almost completely disappeared after these treatment. The detailed information about the histology and radiation dose are not available at the present time. CT scan in our clinic revealed a round low-density area at the suprasellar region and a high density area at the left quadrigeminal cistern. Pineal calcification was compressed to the right about 2-3 mm from midline. This high density mass were not enhanced with contrast medium. Vertebral angiography showed a slight lateral displacement of the left medial posterior choroidal artery. Specimen of tissue removed 20 years ago was reexamined but definitive diagnosis could not be established. Presumptive diagnosis of an ectopic pinealoma in the suprasellar region treated successfully 20 years ago, and its recurrence in the pineal region was made. On May 24, the patient underwent a posterior fossa craniectomy and the pineal region was explored via the infratentorial supracerebellar approach. On sectioning the precentral cerebellar vein, yellowish mass was seen in the quadrigeminal cistern. Aspiration of this mass yielded dark red liquid hematoma. Incising into the capsule, a dark brownish mass of about 4g was removed en bloc.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Hematoma of the pineal region: a case report]. 401 Aug 84

14 patients (13 women, 1 man) presenting with primary empty sella had endocrinologic and radiological investigations. 8 women are obese, 5 multiparous. Initially, headaches have needed a radiological study of sella turcica in 8 cases (57%). Pneumoencephalography and/or CT scan have led to diagnosis; but in 3 cases, a suspected associated pituitary adenoma justified a surgical exploration. In one case, a GH-secreting microadenoma was found, in both other cases histologic studies revealed fibrous or normal pituitary. Endocrine findings were normal, regarding to gonadotrophs, corticotrophs and thyreotrophs. GH was blunted in four cases, below 5 ng/ml during insulin tolerance test. In 9 cases, GH rose to 19,51 +/- 10,03 ng/ml (mean +/- S.D.). In 13 patients, serum prolactin was normal: 7,1 +/- 3,9 ng/ml (normal values 2 -20 ng/ml), elevated in the last case: 112,5 ng/ml. One year later, two patients did not show any modification on clinical, radiological or endocrine data. Physiopathology of intrasellar arachnoidocele is discussed: intrasellar extension of subarachnoid space may be due to diaphragm insufficiency and disturbances of dynamics of cerebrospinal fluid, flattening the otherwise normal pituitary gland.
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PMID:[Primary empty sella turcica. Analysis of 14 cases and review of the literature]. 403 6

We report three cases of coincidental cerebral aneurysm with brain tumor. The incidence of such cases has been said to be 0.3 to 0.7% of all brain tumor cases, and, in our experience, has been 0.9% of 315 patients with brain tumor during the last decade. Case No. 1 was a 60-year-old female suffering from subarachnoid hemorrhage followed by left oculomotor nerve palsy due to rupture of left ICPC aneurysm, with left convexity meningioma which was found incidentally during preoperative cerebral angiography. Case No. 2 was a 47-year-old female suffering from headache, right exophthalmos, and bilateral papilledema. Preoperative CT scan and angiographies revealed right sphenoidal ridge meningioma and unruptured right middle cerebral aneurysm. Case No. 3 was a 28-year-old male with acromegaly. Pituitary adenoma and unruptured anterior communicating artery aneurysm were found preoperatively by CT scan and by angiography, respectively. All cases were well diagnosed preoperatively and surgically treated successfully.
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PMID:[Coincidental cerebral aneurysm with brain tumor: report of three cases]. 404 15


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