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)

A 22-year-old woman with a history of headaches and secondary amenorrhea is reported. Her physical examination showed a visual acuity loss. An endocrine evaluation revealed hypopituitarism and an elevated level of serum prolactin. Polytomography demonstrated an enlarged sella with a double floor. A computerized tomography (CT) scan revealed an enhancing lesion within the sella turcica with an extension into the suprasellar cistern. A lumbar puncture was performed and the cerebrospinal fluid was found to contain no tumor cells. The patient subsequently underwent a trassphenoidal exploration of the sella and an intrasellar tumor removal. A histological analysis of the surgical specimen revealed a germinoma. A total dose of 3500 rads with lineac was applied to the whole brain postoperatively. Her vision is now normal. The pathogenesis of an intracranial germinoma is briefly discussed, and a review of the literature discloses 48 previous reports of germinoma.
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PMID:[Primary intrasellar germinoma with amenorrhea--a case report]. 332 Apr 1

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

The effects of MK-212 [6-chloro-2-(1-piperazinyl)-pyrazine] (10, 20, and 40 mg, orally), a centrally acting serotonin (5-HT) receptor agonist and placebo, on serum cortisol, prolactin, and growth hormone levels were studied in eight healthy men over 3-hr. MK-212 produced a dose-related increase in serum cortisol levels, with the 20- and 40-mg doses producing significant elevations. Serum prolactin levels were significantly elevated only by the 40-mg dose. Serum GH levels were not significantly modified by any dose of MK-212. The cortisol and prolactin responses to the 40-mg dose of MK-212 were positively correlated (rho = + 0.85, p less than 0.02). MK-212 was generally well tolerated by the subjects. Headache and nausea were observed at the higher doses, but did not appear to be related to the increase in serum cortisol and prolactin levels. MK-212 may stimulate the secretion of cortisol and prolactin in humans via a serotonin (5-HT2) receptor mechanism and may be a valuable tool with which to study 5-HT receptor sensitivity in humans.
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PMID:Stimulation of serum cortisol and prolactin secretion in humans by MK-212, a centrally active serotonin agonist. 336 58

Lymphocytic adenohypophysitis is a rare nonneoplastic cause of a pituitary mass. We report the case of an 18-year-old woman who presented with complaints of headaches and visual disturbances after an otherwise uncomplicated pregnancy and delivery. She had an elevated serum prolactin level and a pituitary mass visualized by magnetic resonance imaging (MRI). The tissue removed by transsphenoidal resection was an inflammatory mass composed of lymphocytes, plasma cells, and moderate fibrosis surrounding islands of hyperplastic lactotrophs. This is the first case of lymphocytic adenohypophysitis visualized by MRI. As in this case, lymphocytic adenohypophysitis is frequently confused with a prolactin-secreting pituitary tumor before operation and pathological examination of the tissue. The clinical characteristics and radiological features of and an approach to managing patients with lymphocytic adenohypophysitis are reviewed and discussed.
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PMID:Lymphocytic adenohypophysitis: clinical, radiological, and magnetic resonance imaging characterization. 338 Feb 86

Macroprolactinomas occur rarely in prepubertal children. A prepubertal 11 10/12-year-old female with a macroprolactinoma presented with a diagnosis of anorexia nervosa. Findings included severe headaches, anorexia, weight loss, and growth failure. The initial serum prolactin level was 2,916 ng/ml. This value fell after beginning treatment with bromocriptine, but later rose despite a doubling of the dose. Transsphenoidal surgical resection was performed and postoperative radiation given. The use of bromocriptine, surgical resection, and radiation therapy in the treatment of macroprolactinomas are discussed.
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PMID:Bromocriptine-unresponsive prolactin macroadenoma in a prepubertal female. 341 10

Three cases (2 men, 1 woman) of expansive macroprolactinoma treated with a single 50-mg intramuscular dose of a new form of injectable, long-acting bromocriptine are presented. Clinical manifestations included visual disturbances (2 cases), headache (1 case), and hypogonadism (3 cases). Laboratory tests demonstrated high basal serum prolactin (PRL) levels and evidence of involvement of other anterior pituitary hormones in all cases. Treatment was followed by marked improvement of symptoms paralleled by a sharp decrease of serum PRL levels, which normalized in 1 case. Some other anterior pituitary functions also improved. Computed tomography scan revealed shrinkage of the tumor in all cases. There were no local or serious systemic side effects. These initial findings suggest that long-acting injectable bromocriptine has a place in the initial treatment of macroprolactinomas, especially for those with neurological and/or visual manifestations. It can also be used to select patients for surgery, in the cases where clinical and radiological improvement could not be obtained. The effects of long-term use remain to be established by further studies.
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PMID:Short-term management of macroprolactinomas with a new injectable form of bromocriptine. 358 39

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 19-year-old woman presented with headaches, temporal lobe epilepsy and primary amenorrhoea. There was a family history of multiple endocrine adenomatosis. Investigation revealed normal visual fields and acuity, hyperprolactinaemia (48 000 mU/l) and a very large pituitary tumour with extrasellar spread. Treatment with bromocriptine reduced the tumour size and the prolactin level to 2440 mU/l. Six months after the start of therapy, resistance to bromocriptine developed and the prolactin concentration progressively rose to pretreatment levels, despite increasing the dose of bromocriptine to 40 mg/d. At this stage treatment with a second dopamine agonist, pergolide, was effective in reducing the prolactin concentration to normal within four months. Serial CT scans at 1, 6 and 12 months on dopamine agonist therapy showed a progressive decrease in tumour size, which seemed to be maintained even during the period of rising prolactin concentrations due to bromocriptine resistance. This case illustrates that during dopamine agonist therapy a discrepancy may exist in the clinical response as judged by reduction in tumour size and decrease in the circulating prolactin level. Furthermore, in patients with prolactinomas, pergolide may induce a response when resistance to bromocriptine develops.
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PMID:Discordant responses of prolactinoma to two different dopamine agonists. 374 34

Macroprolactinomas have a well-recognized potential for marked expansion during pregnancy. Measures advocated to minimize this risk include prior treatment with dopamine agonists, radiotherapy and pituitary surgery. We describe a patient who underwent transsphenoidal surgery with the removal of an histologically proven prolactin-secreting adenoma with the intention of rendering subsequent pregnancy safe. The patient remained hyperprolactinaemic and received prolonged therapy with metergoline and bromocriptine which suppressed prolactin to normal and she conceived after induction of ovulation with human menopausal gonadotrophin and human chorionic gonadotrophin. At 3 months gestation she developed headaches, vomiting, reduced visual acuity and bitemporal hemianopia caused by massive pituitary expansion. Reintroduction of bromocriptine rapidly abolished features of tumour expansion and after delivery of a full-term normal female infant, repeat CT scan documented tumour shrinkage.
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PMID:Failure of prophylactic surgery to avert massive pituitary expansion in pregnancy. 379 72

The plasma levels and urinary excretion of the dopamine antagonist, bromerguride, were measured by radioimmunoassay in healthy male volunteers given 50 micrograms i.v. and oral doses of 1 and 2 mg. Plasma prolactin was also measured by radioimmunoassay. Following i.v. injection, the concentration of bromerguride declined biphasically, with half-lives of 7 min and 1.2 h. The total clearance was 32 ml X min-1 X kg-1 and the apparent volume of distribution was 3.61/kg. The bioavailability of oral bromerguride was 29% after 1 mg and 25% after 2 mg. The drug was almost totally metabolized and less than 0.05% of the dose was excreted in urine in 24 h after oral administration. Plasma prolactin levels were increased in a dose-dependent manner for about 8 h. Side-effects were minimal, mainly being tiredness and headache in some of the volunteers.
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PMID:Pharmacokinetics and pharmacodynamics in man of the dopamine antagonist ergot derivative, bromerguride. 380 15


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