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

Thirty-two women with ovarian dysfunction due to hyperprolactinemia were treated with a new derivative of lisuride-terguride. Twenty-three patients were treated for infertility. A microadenoma was confirmed in five, and three other patients had had a macroprolactinoma surgically removed. The finding in one of the patients was diagnosed as the syndrome of empty sella. Galactorrhea was present in 18 women. The duration of treatment ranged from 2 to 33 months. The determination of therapeutic dosages was based on individual responses on the prolactin levels within a range from 0.1 to 4.5 mg per day. Increased prolactin levels were successfully normalized in twenty-one treated patients. Regular periods were reappeared in 59% of the women. Thirteen (56%) became pregnant, seven gave birth to healthy babies, two of the patients aborted in the first trimester. Four women are still in later stages of pregnancy. Galactorrhea disappeared in 56% of the patients, being markedly inhibited in the remaining ones. In two cases, microadenoma disappeared after treatment, and in those after surgery the postoperative findings were decreased, in one patients there is no alteration in the pathology. Side effects were seen in 34% of the patients, being mostly mild in nature, and including in most cases nausea, headache and stomach pain. The complaints were transient, receding after prolonged treatment.
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PMID:Terguride in the treatment of hyperprolactinemia. 215 Feb 71

PMS is probably a group of entities which include various symptoms that occur during the 7 to 10 days before menstruation and disappear a few hours after the onset of menstruation. The definition of PMS lacks objective criteria. The most common symptoms are irritability, bloating, aggressiveness, mastodynia, and headaches. The prevalence of PMS is estimated at 30 to 40 per cent. PMS is more prevalent among women working outside the home, alcoholics, women of high parity, and women with toxemic tendency; it probably runs in families. The etiology of PMS is no less obscure to us than when it was first described by Frank in 1931. No single theory has been established to explain the entire diversity of PMS symptomatology. The multitude of possible etiologic factors includes psychosocial bases, progesterone deficiency, prolactin excess, thyroid hypofunction, renin angiotensin alternations, antidiuretic hormone excess, decreased colloidosmotic pressure, endorphin activity alternations, serotonin metabolism alternations, prostaglandin action, vitamin deficiency, and such unconventional theories as the ovarian infection or the "yeast overgrowth" theory. A partial resolution of this divergence of hypotheses comes from the biopsychosocial model developed by Keye and Trunnel. According to this model, a biologic, perhaps genetically determined, predisposition to PMS is realized when past and present life experiences, attitudes, beliefs, coping styles, and social forces interact to stress a woman. The diagnosis of PMS is based on establishing a relationship between the luteal phase of the cycle and the symptoms. The evaluation of PMS patients includes the use of a monthly diary to scale the symptoms, a physical examination, and biochemical studies to rule out other disorders. Management includes education, reassurance, and drug therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The premenstrual syndrome. 218 58

Many neurologic disorders, such as eclampsia, pseudotumor cerebri, stroke, obstetric nerve palsies, subarachnoid hemorrhage, pituitary tumors, and choriocarcinoma, can develop in the pregnant patient. Maternal mortality from eclampsia, which ranges from 0 to 14%, can be due to intracerebral hemorrhage, pulmonary edema, disseminated intravascular coagulation, abruptio placentae, or failure of the liver or kidneys. Associated fetal mortality ranges from 10 to 28% and is directly related to decreased placental perfusion. Pseudotumor cerebri can be associated with serious visual complications; thus, the therapeutic goal is to prevent loss of vision. The risk of stroke in the pregnant patient is 13 times the risk in the nonpregnant patient of the same age. The major causes of stroke in pregnant patients are arterial occlusion and cerebral venous thrombosis. Lumbar disk prolapse is common in pregnant patients, and lumbosacral plexus injuries can occur during labor or delivery. In addition, peripheral nerve compression or entrapment syndromes are thought to be caused by the retention of fluid during pregnancy. The incidence of subarachnoid hemorrhage during pregnancy is 1 in every 10,000 patients, a rate 5 times higher than in nonpregnant women. Because of a proliferation of prolactin-secreting cells, the pituitary gland can enlarge dramatically during pregnancy, a change that can disclose a previously unknown tumor or cause a known pituitary tumor to become symptomatic. The incidence of choriocarcinoma is 1 in 50,000 full-term pregnancies but 1 in 30 molar pregnancies. This malignant tumor has a high rate of cerebral metastatic lesions. In addition to these disorders that develop during pregnancy, the pregnant state can affect numerous preexisting neurologic conditions, including epilepsy, headaches, multiple sclerosis, myasthenia gravis, spinal cord injury, and brain tumors. We discuss advice for patients with such conditions who wish to become pregnant, recommendations for medical and surgical management, and surgical considerations for neurologic complications during pregnancy.
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PMID:Selected neurologic complications of pregnancy. 225 22

Pseudotumor cerebri, or increased intracranial pressure without a mass lesion, has been associated with hormonal activity but the exact causative relation is still obscure. We report a case of a 15-year-old girl who developed pseudotumor cerebri manifested by headache, visual symptoms and extraocular muscle palsies 3 weeks after recovering from eclampsia. Possible associations with eclampsia and postpartum changes in estrogen, progesterone and prolactin are discussed.
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PMID:Pseudotumor cerebri following eclampsia. 229 29

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

Changes in dopaminergic tonus have been hypothesized in patients with common migraine, suggesting that prolactin may play a role in the pathogenesis of the migraine. We investigated the prolactin response to domperidone, a dopamine receptor blocker. We tested 22 patients with common migraine (8 men, 7 women in the follicular phase of the menstrual cycle, and 7 women in the luteal phase), and 22 normal subjects adjusted for age, sex and phase of the menstrual cycle. Domperidone produced a significant rise of serum prolactin (p less than 0.01) in migrainous patients (7.77 +/- 3.09 vs 71.06 +/- 9.97 in men, 7.05 +/- 2.3 vs 129.58 +/- 14.15 in women in the follicular phase of the menstrual cycle, and 14.28 +/- 3.51 vs 169.71 +/- 16.63 in women in the luteal phase) and control subjects. The response did not show significant differences between migrainous patients and normal subjects. These data do not suggest changes in the tuberoinfundibular dopaminergic tonus in migrainous patients, in contrast to reports of other authors.
Headache 1990 Apr
PMID:Tuberoinfundibular dopaminergic tonus in common migraine. 235 52

Ectopic pituitary adenomas are very rare and only 17 cases have been reported. In this paper we present a case of large pituitary adenoma originating in the suprasellar region. A 26-year-old man was admitted to our clinic with a chief complaint of headaches. Neurological examination revealed slight disorientation and bilateral choked disk. Hormonal study revealed that the serum prolactin level was 3300ng/ml and serum growth hormone level was 29.5ng/ml. Computed tomography showed a large mass in the suprasellar region extending upward to the third ventricle and backward to the pons. T1-weighted MR imaging revealed that the intensity of the mass was the same as that of the cerebral cortex and the pituitary gland was showing high intensity in the pituitary fossa. The tumor was radically removed via the transpetrosal transtentorial approach. Histologically, the tumor was a prolactin-growth hormones producing pituitary adenoma. The literature was reviewed and the origin of the tumor was discussed.
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PMID:[A case of ectopic large pituitary adenoma]. 240 40

To evaluate the change of the neurotransmitter function in migraine, a neuroendocrinological study was performed in eleven female migraineurs and nine female controls. Thyrotropin releasing hormone, luteinizing hormone releasing hormone, and insulin were simultaneously loaded (the Triple test). Before and after loading, serum glucose, prolactin (PRL), thyroid stimulating hormone (TSH), luteinizing hormone, follicle stimulating hormone, adrenocorticotropic hormone, cortisol, human growth hormone and beta-endorphin were measured. The Triple test produced an increase of PRL in both migraine and control groups, but in migraineurs the increase was significantly larger than in controls. TSH also increased in response to the test, but the TSH response in patients was less than in controls, although not significantly so. The responses of other substances showed no significant differences between the two groups. Although dopaminergic hypofunction in migraine has been proposed by some authors, the present findings rather suggest a serotonergic hyperfunction.
Cephalalgia 1989 Sep
PMID:A neuroendocrinological study in female migraineurs: prolactin and thyroid stimulating hormone responses. 250 60

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

Fourteen patients presented with arrested pubertal development associated with prolactin-secreting pituitary tumours; serum prolactin ranged from 4000-104,300 mU/l in the ten females and 920-68,000 in four males. Skull X-ray showed a markedly expanded pituitary fossa in eight patients. CT scan and/or air encephalography showed macroadenomas in nine, of whom seven had large suprasellar extensions to their tumours, yet only five had complained of headache and only two had visual field defects. All were treated with bromocriptine (7.5-60 mg/day) which lowered prolactin substantially in all and into the normal range in 11 (range less than 60-3090, median 105 mU/l). Puberty thereafter progressed spontaneously in 13, but in one patient, whose prolactin did not suppress completely, menarche could be induced only with clomiphene. Anterior pituitary function improved on bromocriptine. In seven patients with macroadenomas, tumour shrinkage into the pituitary fossa was complete and in two others incomplete shrinkage was followed by transsphenoidal hypophysectomy. Seven patients received pituitary irradiation, six after bromocriptine-induced shrinkage and one after transsphenoidal surgery. At follow-up 6 months to 10 years (median 5 years) after presentation, ten remain on bromocriptine with a suppressed serum prolactin, one has a normal prolactin after surgery, and three are off bromocriptine with residual hyperprolactinaemia (418-4680 mU/l). To date, four females have become pregnant and one male has fathered two children. Prolactinomas are an important, albeit rare, cause of arrested puberty and should therefore be sought. Most patients respond well to bromocriptine, with or without pituitary irradiation.
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PMID:Prolactinomas presenting as primary amenorrhoea and delayed or arrested puberty: response to medical therapy. 261 15


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