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)

Chronic treatment with beta-blockers was interrupted abruptly in six patients with arterial hypertension. Three patients, who had experienced symptoms during a previous withdrawal, again complained of transient palpitations, tremor, sweating, headache and general malaise. A significant increase in standing blood pressure (BP) and heart rate (HR) was noted after 24 h. The standing HR reached a maximum after 48 h and had decreased significantly on the 7th day (p less than 0.005). There was a strong tendency to greater increase in standing BP and HR in the patients who experienced symptoms than in those who did not. Plasma concentrations of noradrenaline, adrenaline and prolactin did not change significantly. Thus, beta-blocker withdrawal symptoms are reproducible and are indicative of a transient sympathetic hyperresponse. The increased activity is not likely to be caused by increased production of circulating catecholamines, but rather by increased sensitivity of the beta-receptor.
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PMID:Abrupt withdrawal of beta-blocking agents in patients with arterial hypertension. Effect on blood pressure, heart rate and plasma catecholamines and prolactin. 3 93

In a clinical survey the relation between migraine and menstruation was studied in 142 otherwise healthy women. In 24, onset of migraine coincided with the year of menarch. Of the 138 patients in whom onset of migraine predated the menopause, there were only 13 in whom attacks occurred regularly, and only, just before or during menstruation; in a further 11 attacks occurred regularly in relation to menstruation and at other times. Those with menstrually related migraine were more likely to have onset of migraine at menarche, to have associated weight gain and breast discomfort as part of a periodic syndrome, and to show improvement during pregnancy. There appeared no clear pattern of change at the menopause. In a study of reproductive hormones, blood was collected daily throughout a menstrual cycle from each of 8 women with menstrually related migraine, 6 with menstrually non-related migraine, and 8 healthy headache-free controls. Plasma levels of follicle-stimulating hormone (F.S.H.), luteinising hormone (L.H.), prolactin, oestrogen, and progesterone were measured in all. Plasma-testosterone was measured in 8 migraine patients. Mean plasma oestrogen and progesterone levels were significantly higher in migraine patients than controls for most of the menstrual cycle, with the most striking differences found in the late luteal phase for progesterone. No significant difference was found between the menstrually related and non-related patients for these or the other hormones measured. Mean plasma-prolactin levels were lower in migraine subjects than controls, but the difference was not significant. Mean plasma F.S.H. and L.H. levels were similar in both migraine and control groups. Plasma-testosterone levels were within the range for normal in the 8 migraine patients studied. No specific hormone changes were associated with the occurrence of a migraine attack, nor did rising or falling levels, or greater increments of change over given cycle phases, appear important in provoking attacks.
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PMID:Migraine and reporoductive hormones throughout the menstrual cycle. 4 17

A boy aged 9 years and 8 months was evaluated for headache and an enlarged sella. His neurological status and visual fields were normal. After injection of radiographic contrast agent, computerized axial tomography showed evidence of an intrasellar tumor. The most striking endocrine abnormalities were growth hormone insufficiency after arginine infusion and after insulin-induced hypoglycemia, and excessively elevated prolactin levels ranging between 1220 ng/ml and 1560 ng/ml. A slightly granulated, acidophilic pituitary adenoma was selectively removed by the trans-sphenoidal approach. The function of the anterior pituitary improved post-operatively. Growth hormone secretion after insulin-induced hypoglycemia returned to normal, and the basal serum prolactin levels decreased, but are still three times higher than normal.
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PMID:Prolactin-producing pituitary adenoma in a 9 year old boy. 21 87

A 25-year-old woman was seen for the complaint of secondary amenorrhea. Skull roentgenograms revealed a markedly enlarged sella turcica. Studies of pituitary and hypothalamic function including prolactin were normal. A pneumoencephalogram revealed dilated ventricles and a mass in the septum pellucidum and hypothalamus. Partial removal of this hypothalamic astrocytoma and placement of an interventricular shunt resulted in the return of menses. Recurrent obstruction a few months later resulted in headache, disorientation, and amenorrhea. A shunt was placed again, resulting in clearing of symptoms and a reestablishment of normal menstrual cyclicity. It appears that the occurrence of increased intracranial pressure rather than the hypothalamic tumor caused the amenorrhea.
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PMID:Hydrocephalus and amenorrhea. 36 93

Observations are reported on 41 pregnancies in 27 patients who initially had infertility and raised serum prolactin concentrations. Associated symptoms were secondary amenorrhoea (81 per cent) and galactorrhoea (81 per cent). All patients were at risk of pituitary expansion during pregnancy, especially these 19 (70 per cent) with radiological evidence of pituitary tumours. Fifteen patients had 21 pregnancies after pituitary implantation with 90yttrium; 14 patients had 20 pregnancies without prior pituitary implantation or any other attempt to prevent tumour expansion. During pregnancies, tumour enlargement as shown by diminished visual acuity, visual field defects, severe headaches, diabetes insipidus and radiological changes occurred only in 3 of the 14 patients who had not had implants. Two patients who became pregnant both before and after pituitary implantation suffered tumour expansion in their pregnancies before implantation, but not when pregnant after the operation. The induction and Cesarean section rates were about 30 per cent in 32 term pregnancies in 25 patients. Details of how pregnancy was achieved and the associated obstetric problems are given.
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PMID:Pregnancies in women with hyperprolactinaemia: clinical course and obstetric complications of 41 pregnancies in 27 women. 49 42

In the increasing cohort of patients being observed after pituitary microneurosurgery for prolactin-secreting adenomas, tumor recurrence remains a concern. We describe a patient with a prolactinoma treated by transsphenoidal pituitary surgery who resumed cyclic menses for one year postoperatively before manifesting progressive headaches, intermittent diplopia, secondary amenorrhea, and anterior pituitary failure. Invasive and noninvasive neuroradiologic procedures suggested recurrent tumor with suprasellar extension. However, reoperation of the pituitary disclosed a chronic intrasellar hematoma expanding under increased pressure within the enclosed sellar space. We discuss a putative mechanism for the pathophysiology of this syndrome, and tentatively designate it "pituitary pseudotumor". Recognition of this entity is important not only because reoperation is required for accurate diagnosis, but also because treatment with radiotherapy or bromocriptine mesylate for presumptive tumor progression or recurrence would be ineffective.
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PMID:Pituitary pseudotumor. Mimicry of recurrent prolactinoma by a chronic intrasellar hematoma. 50 30

Eight adolescent patients, 4 boys and 4 girls with prolactin secreting pituitary adenomas have been studied. The first symptoms developed between the ages of 8 and 14 years. The main complaints were headache (7 cases), delay or failure of growth (6 cases) or of puberty (3 cases), and amenorrhoea with galactorrhoea (2 cases). The diagnosis could be made easily from the enlarged sella turcica and the high plasma prolactin levels. Anterior pituitary insufficiency is variable. Persistent hyperprolactinaemia after surgery may require treatment with bromocriptine.
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PMID:[Prolactin-secreting pituitary adenomas in children and adolescents. Study of a series of 8 cases]. 53 71

10 amenorrhea-patients and 5 galactorrhea-amenorrhea-patients were treated wi2-Br-alpha-ergocryptine (CB 154) as a specific prolactin inhibitor. Side-effects, such as headaches, dizziness, and nausea could be reduced to a minimum by delivering the drug with the meal at night. Before and under the treatment hormone levels were determined in plasma and 24-hour-urine. In the beginning all 15 patients showed a hyperprolactinaemia with a nearly always simultaneously existing hypogonadotropinaemia and the absence of LH-peaks. Also the estrogen- and progesterone-concentrations were on the lower normal level or extremely suppressed. In all patients CB 154 therapy led to a quick decrease of the prolactin levels, to a regaining of typical LH- and FSH-episodes, as well as to a regeneration of ovarian function. 5 women reacted with an ovulation, 3 became pregnant. The galactorrhea diminished significantly and stopped finally after a treatment of one week to 6 months. Discontinuation of CB 154-therapy, however, often provoked the galactorrhea-amenorrhea-syndrome again. For women with normoprolactinaemic amenorrhea a gestagen- and estrogen-test were carried out in order to classify the amenorrhea-type and it was tried to induce an ovulation with Dyneric. For patients with a strong desire for children and without any organic cause for their sterility, in cases of ovarian insufficiency grade I and II a HMG-HCG-treatment was often indicated. In spite of a precise control in order to avoid an overstimulation of the ovaries about 1% of the Dyneric-treated and even 30% of the HMG-HCG-treated patients developed ovarian cysts. In spite of high doses of gonadotropins only 32,5% of our sterility-patients (group I and II) became pregnant, whereas about 60% of the hyperprolactinaemic amenorrhea-patients (group VI) conceived under CB 154 treatment.
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PMID:[Hyper- and normoprolactinaemia with amenorrhea and galactorrhea-amenorrhea-syndrom (author's transl)]. 58 43

Fifty-one female patients with prolactin producing tumors (PRL 1100 to 88,000 microU/ml) and 26 male patients with prolactin producing tumors (PRL 6500 to 400,000 microU/ml) were studied. Only 25% of the females had visual field defects which were present in 70% of the males. All females had amenorrhea but only 35 had galactorrhea. Hypopituitarism was rarely seen in the females but in most of the male patients. Twenty-four females and all male patients were operated (transphenoidal or transfrontal operation). PRL normalized in only eight females and in none of the males. Two patients became pregnant postoperatively, four after postoperative treatment with bromocriptine. Bromocriptine induced regular menses in 4 other patients operated by transsphenoidal route. Eight patients with microadenoma (PRL less than 4000 microU/ml) were treated with bromocriptine alone of whom two became pregnant. The males were also treated with bromocriptine leading to a significant fall of the PRL level accompanied by improvement of libido, sexual potency and headache. Two patients received radiation postoperatively, which led to a fall of PRL and improvement of visual fields. Since PRL levels remained low after withdrawal of bromocriptine for several months an antiproliferative effect of this drug is suggested. Thus differential therapy of PRL producing tumors is possible: In females selective neurosurgery can alone or combined with medical therapy normalize PRL secretion and ovarian function. In patients with microadenoma bromocriptine alone can be successful. In patients with inoperable large tumors radiation should be advocated. Additional bromocriptine therapy may be helpful to stop tumor growth and alleviate the effects of hyperprolactinemia.
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PMID:Treatment of patients with prolactinomas. 75 42

This study was undertaken to determine the prevalence of radiologically detectable pituitary tumors among patients seen initially in a gynecology clinic for a complaint of secondary amenorrhea. In a group of 144 women with secondary amenorrhea of more than 6 months' duration, 13 had radiologic abnormalities of the sella turcica detectable with standard skull films without tomography. These gynecologic patients composed more than half of the women in the reproductive age group who were diagnosed at this medical center as having a pituitary tumor. Only one patient with oligomenorrhea or secondary amenorrhea of less than 2 years' duration had a detectable tumor. Thus, for patients with short-term amenorrhea, the risk of having a pituitary tumor is small, especially in the absence of galactorrhea, headache, or changes in vision. However, 12 of 71 patients with amenorrhea longer than 2 years (17%) had detectable tumors and the risk appears to increase progressively with time. Assay of adrenal and thyroid hormones did not discriminate between patients with and without pituitary tumors. Early detection of these tumors is aided by serial sella x-rays, tomograms, prolactin assays, and newer pituitary function tests. Patients presenting with postpill amenorrhea and postpartum amenorrhea illustrate the hazard of interpreting a temporal relationship as a causal one.
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PMID:Pituitary tumors in patients with secondary amenorrhea. 93 1


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