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

The amenorrhea-galactorrhea syndrome which occurs at a time other than the post-partum period is most often seen in association with a tumor of the pituitary gland; the symptoms are caused by a hypersecretion of prolactin. Among a series of 19 patients in Tel Aviv who underwent surgery for treatment of pituitary tumors, 2 presented with the amenorrhea-galactorrhea syndrome. The first patient, a 16 year old, presented with headaches, nausea, and diplopia; she underwent a series of 3 surgical procedures and died of a respiratory arrest in the third post-operative period. The second patient was a 39 year old woman who had borne 5 children; she presented with loss of vision, underwent surgery, and did well post-operatively. The authors point out that whereas either amenorrhea or galactorrhea alone may be associated with a number of disorders, the combination of the two symptoms is characteristic of pituitary tumors. Both patients who were presented in this article had chromophobe adenomas of the pituitary. The authors also discuss the various biologic actions of prolactin and its interrelationships with other hormones.
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PMID:[Pituitary tumors manifesting with amenorrhea-galactorrhea]. 96 24

A female case of precocious puberty associated with HCG-producing ectopic pinealoma was reported. The patient, a 5-year-old girl, was referred to the hospital because of headache and choked discs. Physical examination revealed normal physical growth with breast enlargement. Endocrinological study revealed a high plasma HCG concentration of 1192 ng/ml with a normal FSH level. None of HCG, LH and FSH did respond to the LH-RH test. A partial resection of the tumor and an external X-ray irradiation relieved the symptoms and breast enlargement subsided with a remarkable decrease in the plasma HCG level. Histological examination revealed two-cell-pattern pinealoma and electron microscopic findings showed abundant secretory granules in the dark cells. HCG content in the tumor was as high was 400 ng/mg of acetone dried tumor tissue, but no FSH was detectable. Hitherto, all of the reported cases of precocious puberty associated with pineal tumors have been exclusively boys. A normal level of plasma FSH concentration with a somewhat elevated prolactin level might be a contributory factor for the development of precocial sexual development in the present case.
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PMID:A female case of the HCG-producing ectopic pinealoma associated with precocious puberty. 99 33

This study reports a case of allergy to ergot-derived drugs in a patient with a prolactin (PRL)-secreting microadenoma. The anamnesis revealed allergic reactions to the administration of analgesics and antibiotics. The administration of dopamine agonist drugs, such as bromocriptine (BRC; 2.5 mg) or lisuride (0.2 mg), induced after a few minutes the appearance of nausea, vomiting, postural hypotension, headache, edema of the glottis with dispnea and acroedema. The edemas disappeared a few hours after the administration of antihistaminic drugs while nausea, vomiting, postural hypotension and headache persisted for a few days. Therefore, the patient was tested with another dopamine agonist non-ergot-derived drug, quinagolide (CV 205-502), which did not cause side effects or allergic reactions. Furthermore, not only was the responsiveness to the drug optimal but it also normalized the PRL levels, and menses reappeared after more than a 5-year amenorrhea. This report suggests that ergot-derived drugs, such as lisuride and BRC, seldom induce allergic reactions apart from common side effects. Consequently, the feasibility of using a new drug with a different molecular structure (non-ergot derived) effective in the therapy of hyperprolactinemic syndromes represents a good alternative to conventional therapy.
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PMID:Usefulness of CV 205-502 in a case of allergy to ergot-derived drugs. 130 52

A total of 14 patients (8 males and 6 females) with nonfunctional pituitary adenomas were diagnosed and underwent surgical intervention at the Kaohsiung Medical College Hospital between 1986 and 1991. Their ages ranged from 20 to 68 years with an average of 49.7 years. Eight adenomas were composed of small polygonal cells with chromophobic cytoplasm and other six were of large cells with pale eosinophilic granular cytoplasm. Immunohistochemical staining had negative staining of prolactin (PRL), growth hormone (GH), adrenal corticotropic hormone (ACTH) and thyroid stimulating hormone (TSH) in all cases, but scattered or wide spread cells containing alpha-subunit of glycoprotein hormones were found in 6 cases. Hormonal hypersecretion was absent in all of the clinical and biological pictures, as was reactivity to immunohistochemical examination. There were either very few signs of secretory activity, or none at all. CT and MRI scanning revealed 13 macroadenomas (92.9%) and one microadenoma. In seven cases, local invasion or suprasellar extension resulted in decreased visual acuity, but the most common clinical symptoms were progressive headache (78.6%), and visual disturbance (50.0%). After surgical intervention, symptoms disappeared in 74.2% of the patients.
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PMID:Nonfunctioning pituitary adenoma. 133 19

Pituitary Apoplexy is a rare but sometimes life threatening condition which requires prompt recognition and timely medical intervention to avoid catastrophic consequences. From January 1979 to June 1989 and total of one hundred and ninety eight pituitary tumor patients were operated on our hospital. Eighteen cases (9.1%) were diagnosed "pituitary apoplexy" according to histopathological findings. The group consisted of twelve men and six women ranging in age from twenty two to sixty one years with a mean of forty. There were three cases of prolactin-secreting adenomas (16.7%), four growth-hormone secreting adenomas (22.2%), and eleven nonfunctional adenomas (61.1%) with an incidence of 6.1%, 8.3%, and 11.4% respectively (P > 0.05). Clinical manifestation occurred acutely in 66.7% and nonacutely in 33.3%. The patients presented with headaches (100%), visual impairment (83.3%), visual field defects (66%), disturbed consciousness (22%), fever and meningismus (11%). Radiological examinations able to demonstrate abnormalities included plain skull films (84%), computed tomography (84.6%), and angiography (93.8%). Various investigations of endocrine function pre and post operatively showed a deficient gonad axis (53%, 62.5%), adrenal axis (26.7%, 56.2%), and thyroid axis (20%, 43.8%). Sixteen cases received a transsphenoid operation and three cases underwent a transfrontal craniotomy. No case of mortality was reported. Postoperative radiotherapy was given to nine cases and nine cases were followed up on a regular basis. Therefore, our retrospective study suggests that pituitary apoplexy is not uncommon and has an acute clinical presentation. No particular tumor type was prone to occur. Various radiological examinations could define perisellar abnormalities. With a decreasing order of hormone deficiency, gonad, adrenal and thyroid axis were observed during the course of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Pituitary apoplexy: a study of eighteen cases]. 133 26

Cerebrospinal fluid (CSF) leakage is a rare complication of prolactinoma treated with bromocriptine (BC). BC is known to be effective for reducing the volume of a prolactinoma and for decreasing the serum level of prolactin (PRL). In cases of pituitary tumors, CSF leakage is thought to be caused by shunting between the subarachnoid and extradural spaces. We had a case presenting with CSF rhinorrhea and CSF otorrhea during BC therapy which was treated successfully. The mechanism and treatment of CSF leakage were studied. A 55-year-old woman complaining of nasal obstruction and headache was admitted to our hospital on Nov. 22, 1988. CT scan showed a huge intracranial mass lesion involving the sella and the supra-sellar region and invading the sphenoid sinus and ethmoid sinus. Serum PRL level was 18,000 ng/ml. The patient was diagnosed as having an invasive prolactinoma, and BC therapy (5.0 mg per day) was instituted. Three days later, CSF rhinorrhea developed, and BC treatment discontinued; radiation therapy was started. After 36 Gy irradiation the size of the tumor was same on CT, and serum level of PRL was still high. The patient underwent trans-sphenoidal operation. The tumor was removed partially and the presumed CSF fistula was repaired. The sella and sphenoid sinus were packed with fat. BC treatment was reinstituted, and the serum PRL level decreased gradually without recurrent CSF rhinorrhea. Two weeks later the patient returned complaining of bilateral hearing disturbance. With a diagnosis of exudative otitis media she underwent bilateral tympanostomy. Immediately after tympanostomy, pulsating discharge from the middle ear was observed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of prolactinoma presenting with CSF rhinorrhea and CSF otorrhea during bromocriptine therapy]. 140 45

A 44-year-old male suffered epistaxis and headache of sudden onset and was diagnosed as having suppurative meningitis due to streptococci. Four days after the onset of symptoms, he died despite treatment with antibiotics. Destruction and ballooning of the sella turcica was revealed by a plain head X-ray examination during the clinical course. At autopsy, a massive tumorous lesion extended from the ballooned sella turcica to the paranasal cavities, nasopharynx and facial bone, and this had resulted in suppurative meningitis. The tumor was also disseminated to the basal skull. The tumor cells possessed prominent nuclear atypia and were immunohistochemically positive for prolactin. This was diagnosed as a case of pituitary adenoma with markedly invasive pathological findings and a rapid and fatal clinical course.
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PMID:An autopsy case of invasive pituitary adenoma (prolactinoma) with rapid fatal clinical course due to streptococcal meningitis. 147 31

In 12 cases of pituitary apoplexy, a preexisting unsuspected adenoma was found. The initial manifestations were sudden onset of headache (12 patients), signs of meningeal irritation (10) with fever (four), altered consciousness (12), and ophthalmologic disturbances (eight). The diagnosis was retrospective in three cases. Radiologic investigations were always suggestive if carefully considered. The plain skull roentgenograms, in particular, showed an enlarged sella turcica in 11 cases. Three patients had prolactin adenomas, and nine had nonfunctional adenomas. Medical treatment was successful in only three patients; surgery was performed in 10 cases by means of a sublabial transseptal microsurgical approach. Postoperative neurologic complications were serious in two cases. Endocrine insufficiencies were common: eight cases of permanent panhypopituitarism, two cases of pluritropic anterior pituitary dysfunction, and three cases of persistent hyperprolactinemia.
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PMID:Twelve cases of pituitary apoplexy. 837 8

A single oral dose of 500 mg sodium valproate had no effect on prolactin, growth hormone and cortisol secretion in 10 migraine patients when compared with five healthy controls and four migraine patients receiving placebo. Basal values of prolactin (PRL), cortisol and growth hormone (GH) were within the normal range, though PRL basal levels were lower in three patients (21.5%) in the migraine group.
Cephalalgia 1992 Aug
PMID:Effect of sodium valproate on the secretion of prolactin, cortisol and growth hormone in migraine patients. 152 1

Macroprolactinomas have been well documented in men over the past several years. By contrast, to the best of our knowledge, there have been no reports of microprolactinomas in men. We describe here 14 cases of microprolactinomas occurring in male patients (14 to 53 years old) and discovered on the basis of endocrine symptoms. Nine patients complained of impotence and/or decreased libido, 8 had gynecomastia with or without galactorrhea, 1 had undergone incomplete puberty. All patients had hyperprolactinemia (225 +/- 65 micrograms/l, mean +/- SEM, N less than 13 micrograms/l); plasma testosterone levels were low in 9 (162 +/- 33 ng/dl, mean +/- SEM; N = 308 - 876 ng/dl), while plasma luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels and their responses to LH-releasing hormone (LHRH) were normal in all cases. Among the 14 patients, 12 had no hypopituitarism and 2 had only partial corticotrope insufficiency; none had visual disturbances and only one complained of headaches. The sella turcica was normal in size and shape in 2 cases but a double floor and/or a thinner part of the floor was observed in 12. CT scan of MRI demonstrated in all cases an intrasellar microadenoma with a mean size of 7 mm (range, 3 to 10 mm) and no preferential localization. One patient was treated with bromocriptine, while the others underwent surgery via the transsphenoidal route. Immunocytochemistry demonstrated immunoreactive-prolactin (IR-PRL) cells in all the adenomas. Surgery resulted in normalization of plasma PRL in 11 of the 13 patients and in lowering PRL levels in the others 2.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Prolactin microadenoma in men. Study of 14 cases]. 153 Feb 27


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