Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Altogether 45 patients (41 women and 4 men) with benign intracranial hypertension (BIH) were observed. BIH developed in 22 women in the gestation period, in 4 during a menopause, in 2 in the presence of hypothyroidism, in 2 due to respiratory infection, in 2 due to a slight cerebrocranial injury, and in one patient with associated galactorrhea-amenorrhea. The cause of BIH in 12 patients remained unclear. Most of the women were obese (33 of 41). The clinical picture of BIH consisted of headaches, congested optic discs, and elevated pressure of cerebrospinal fluid. In most cases prognosis turned out favorable. In the residual period, 1 patient had amaurosis, 25 presented with mild headache, 19 completely recovered. Three women had recurrent BIH.
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PMID:[Benign intracranial hypertension syndrome]. 229 Mar 26

9 women and 6 men with prolactin-secreting pituitary tumors--prolactinomas (mean age 41 years, range 28-57), were treated conservatively with bromocriptine. The women usually presented with galactorrhea, menstrual disorders and headaches, and the men with headaches, decreased libido or impotence, and visual abnormalities. The symptoms had lasted from several months to 20 years, but were not correlated with tumor size. Between 77-100% of symptoms improved during bromocriptine. Prolactin levels, which correlated with the size of the tumor, averaged 1241 ng/ml before treatment and became normal in 80% of the patients. Tumor size decreased in 58% of those with macroprolactinomas. Lesions of decreased density were found in another 17% of the patients. Side-effects of bromocriptine were minor and disappeared despite continuation of therapy. The results of this series, as well as those of others, indicate that bromocriptine is the treatment of choice for micro- and macroprolactinomas.
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PMID:[Treatment of prolactin-secreting pituitary tumors with bromocriptine]. 234 Oct 64

CV 205-502, a new long-acting nonergot dopamine agonist, was given to 15 patients (6 women and 9 men) with PRL-secreting pituitary macroadenomas. The compound was administered in a single daily dose for a period of 6-12 months. The treatment resulted in normalization of plasma PRL levels (less than or equal to 20 micrograms/L) in 5 of 6 women at a mean dose of 135 micrograms (range, 75-300 micrograms) and in 6 of 9 men at a mean dose of 192 micrograms (range, 75-300 micrograms). Among patients for whom computed tomographic scans were available before and after at least 6 months of therapy, definite tumor shrinkage occurred in 6 of 7 patients. Libido was improved in 5 of 6 women and in 6 of 8 men, galactorrhea disappeared in all cases (3 women and 1 man) and menses resumed in 3 of 5 women. Plasma testosterone rose to normal levels in 3 of 6 men who were not receiving testosterone injections. The PRL response to TRH was blunted in 4 of 6 patients with normalized basal PRL. Serum total cholesterol was reduced by CV 205-502 treatment in women from 5.35 +/- 0.49 to 4.63 +/- 0.51 mmol/L (P = 0.031) and in men from 5.93 +/- 0.89 to 5.28 +/- 0.82 mmol/L (P = 0.045). Side-effects included mainly headache, nausea, and dizziness. One side-effect or more occurred transiently and with mild intensity in 14 patients. No patient discontinued the therapy because of side-effects. In conclusion, CV 205-502 appears to be a safe and valuable compound in the treatment of patients with PRL-secreting macroadenomas.
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PMID:Long term treatment with CV 205-502 in patients with prolactin-secreting pituitary macroadenomas. 239 74

CV 205-502 is a nonergot oral dopamine agonist with specific D2 activity, which has a prolonged suppressive effect on serum PRL and may have fewer side-effects than other dopamine agonists. We treated 26 hyperprolactinemic women with this compound given as a single bedtime (hs) dose for up to 12 weeks. All had gonadal dysfunction, either amenorrhea or oligomenorrhea, and 15 had galactorrhea. The initial and subsequent doses were administered in a randomized fashion; the initial dose ranged from 0.01-0.05 mg, and the dose at 12 weeks ranged from 0.03-0.09 mg. The women were evaluated every 2 weeks, and the dose was increased by 0.02 mg every 4 weeks if the serum PRL level was greater than 20 micrograms/L. Of the 26 women initially enrolled, 24 completed 12 weeks of therapy, and 2 discontinued therapy because of side-effects. Thirteen women (54%) had return of menses, and 12 (80%) had either a decrease in or disappearance of galactorrhea. Serum PRL concentrations decreased to a variable degree in all patients; 13 (54%) achieved a normal serum PRL level (less than or equal to 20 micrograms/L). The mean (+/- SE) pretreatment serum PRL concentration was 129 +/- 34, and it was 29.9 +/- 5.9 micrograms/L after 12 weeks of treatment (P = 0.005). The mean (+/- SE) percent reduction in serum PRL was 66.5 +/- 5.0% (median, 78.0%). A dose response was not demonstrated (r = -0.08; P = 0.70) among the 6 dose groups during the last 4 weeks of therapy. In 5 women, serum PRL levels, measured frequently for 24 h after treatment remained low. Side-effects after the initiation of therapy included nausea, headache, and morning fatigue in 10 women. These symptoms caused 2 women to discontinue therapy; they subsided in the other women. An optimal dose was not determined and will probably need to be determined by titration in each patient. CV 205-502, given once daily, appears to be a safe and effective alternative to other dopamine agonists in the treatment of hyperprolactinemia.
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PMID:CV 205-502 treatment of hyperprolactinemia. 252 63

A mixed gangliocytoma-adenoma occurring in the pituitary fossa of a patient who presented with acromegaly, galactorrhea, and headaches is described. Immunohistochemical studies demonstrated the gangliocytic portion of the tumor to be composed nearly entirely of ganglion cells enmeshed in their neuritic processes and disclosed focal presence of growth hormone and prolactin-secreting cells in the adenoma. Ultrastructurally, some of the larger ganglion cells contained (and were often filled with) zebra-like bodies, while the adenoma was shown to be sparsely granulated with numerous fibrous bodies. These findings support the term of mixed gangliocytoma-adenoma for these rare intrasellar tumors and provide additional support for their nature as independent neuroendocrine units.
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PMID:Mixed gangliocytoma-adenoma: a distinct neuroendocrine tumor of the pituitary fossa. 259 50

Primary hypothyroidism may be associated with enlargement of the sella turcica, due to thyrotroph hyperplasia, in its turn due to the lack of feedback control by thyroid hormones. It may develop independently of the severity or of the duration of thyroid failure. A 42-year-old woman was referred to us. She presented us with a CT scan compatible with a pituitary microadenoma, in the left part of the sella. The patient showed obvious signs of myxedema, due to subtotal thyroidectomy which had been performed 14 months before, because of the presence of multinodular goiter. After operation, the patient has been discontinuously and inappropriately treated with desiccated thyroid. She complained of headache, nausea, galactorrhea without amenorrhea. Serum T4 (0.8 micrograms/dl), serum T3 (47 ng/dl) and TSH (174.5 +/- 60.1 mU/l: M +/- SD of 4 assays) were compatible with primary hypothyroidism as confirmed by TSH hyper-response to i.v. TRH (200 micrograms) and i.v. domperidone (10 mg), and by the normal TSH decrease after orally administered 2.5 mg bromocriptine or 90 min continuously infused 800 micrograms GHIRH. Moreover, an abnormal GH response to TRH was observed, whereas basal and appropriately stimulated PRL levels were normal. Serum alpha-subunit was marginally high (5.92 ng/ml), but alpha-subunit/TSH molar ratio fell within the normal range (0.1 molar ratio). Complete suppression of basal and TRH stimulated TSH values was achieved after a 14-day L-T3 (120 micrograms per day) and 4-month L-T4 (200 micrograms per day) administration. L-T4 treatment, first administered at suppressive doses (200 micrograms per day for 4 months) and subsequently at substitutive doses (150 micrograms per day for 2 months), induced complete remission of symptoms along with normalization of the CT scan picture.
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PMID:Pituitary enlargement in post-surgical hypothyroidism misdiagnosed as thyrotroph neoplasia. Report of a case. 262 26

A 43-year-old man was admitted to our clinic with complaints of headache and nasal obstruction. He has noted increasing hand and foot size with decreasing libido and pollakiuria for ten years. On admission, he showed galactorrhea. His visual symptoms were slightly decreased. Endocrinological evaluation revealed high serum levels of GH and prolactin. A plain skull X-ray showed acromegalic features with remarkable destruction of dorsum sellae. A contrast enhanced CT demonstrated an intrasellar high density mass extending to the sphenoid sinus and the right ethmoidal sinus. A cerebral angiogram was nor.al. Surgery was then performed with the transsphenoidal approach. A soft reddish brown mass was found in the sphenoid sinus and the bilateral cavernous sinus extending from the sella turcica. Histologically the tumor was eosinophilic adenoma. There were numerous cells exhibiting immunostaining for both GH and PRL in the immunocytochemical study. Postoperative course was uneventful. His visual impairment improved soon after the operation. Serum GH and PRL levels decreased to 38 and 130 ng/ml. He was treated with conventional irradiation (500 rads), so remained galactorrhea and hyperhidrosis. One year after the operation, there is no regrowth of the residual tumor.
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PMID:[A case of male acromegaly with galactorrhea]. 284 24

Four cases of pneumosinus dilatans of the sphenoid sinus are reported, supplementing the eight cases previously reported in the literature. This rare entity is characterized by expansion of a paranasal sinus that contains only air. In one patient, severe visual loss due to compression of the optic canal by the adjacent enlarged sinus was seen. Galactorrhea occurred in one patient, and three of the four patients reported headaches. There was dehiscence of the sinus roof in two cases, which apparently resulted in a cerebrospinal fluid fistula in one. Previous reports of this entity are reviewed, and the radiographic findings and clinical presentations are discussed. It is proposed that the term "pneumosinus dilatans" be used to describe all dilated, air-filled sinuses with outwardly bulging walls when the primary cause is uncertain.
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PMID:Pneumosinus dilatans of the sphenoid sinus. 309 5

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

Thirteen pathologically documented intrasellar arachnoid cysts treated by transsphenoidal cyst excision and marsupialization were analyzed. Presenting symptoms included headache (7), visual loss (7), galactorrhea (4), and anterior pituitary dysfunction (2). Postoperatively, the 7 patients with visual loss and 4 with hyperprolactinemia improved. The 2 patients with anterior pituitary dysfunction did not improve and 2 additional patients required hormonal supplements. Based on this operative experience, the pathophysiology of these cysts is discussed. The indications for transsphenoidal exploration include the following: to relieve optic chiasm, pituitary stalk or gland compression, and to exclude the possibility of other sellar neoplasms.
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PMID:Intrasellar arachnoid cysts. 360 51


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