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

The authors reported a case of pneumocephalus induced by bromocriptine (Bc) treatment for a recurrent invasive prolactinoma. The patient was a 38-year old man, who had been treated for 12 years, with three times of craniotomies and two times of irradiation therapies. CT scan showed the recurrence of the tumor, which extended into bilateral middle fossa, left orbit and left cerebellopontine angle. Serum prolactin levels elevated to 35,200 ng/ml. Then Bc was administered in a dose of 5 mg/day. Serum PRL concentration fell to 2,090 ng/ml one month after the initiation of the treatment, when he complained of headache, nausea and vomiting. Since these symptoms were considered as the side effects of Bc, the dose was reduced to 2.5 mg/day. Three weeks later, plain craniograms showed marked pneumocephalus, while no tumor was found on CT scan. The administration of Bc was stopped and he was prescribed a complete rest for a month. The air was collected again when he began to walk around. Therefore, the transsphenoidal operation was performed in order to pack the sella turcica and sphenoid sinus with muscle pieces. Since the pneumocephalus could not be cured, the muscle, taken from the thigh, was spread throughout the left middle fossa by the front-temporal craniotomy. When Bc reduces the size of the invasive prolactinomas, the intra- and extra-cranial spaces may be communicated. The greatest care should be taken for pneumocephalus, CSF rhinorrhea and/or meningitis during the Bc treatment of prolactinomas.
 ...
PMID:[Pneumocephalus induced by bromocriptine treatment in male prolactinoma--a case report]. 666 17

Thirty-eight patients underwent transsphenoidal microsurgical treatment of non-neoplastic intrasellar cysts: 36 had cyst drainage and biopsy of the cyst wall, and in two the cyst was totally removed. Surgical morbidity was 8%. The mean follow-up time was 46.3 months; 100% patient follow-up evaluation was achieved. Sixteen female patients (mean age 24.6 years) had pars intermedia cysts: 88% had menstrual irregularities, 63% had galactorrhea, 31% had headache, and 56% had hyperprolactinemia. Within these groups, menstrual cycles returned in 86%, galactorrhea ceased in 90%, headaches resolved in 80%, and serum prolactin levels were restored to normal in 66%. Eight females and three males had Rathke's cleft cysts (mean age 34.0 years): of these 11 patients, 91% had headaches and 18% had hyperprolactinemia; of the eight females, 63% had amenorrhea and 63% had galactorrhea. Within these groups, serum prolactin levels normalized in 50%, and 80% noted reduced headache. Of the females, 80% had return of menses and 50% noted cessation of galactorrhea. Six males and two females had arachnoid cysts (mean age 42.2 years): 50% had headaches; 50% were asymptomatic. Preoperatively, 50% of these patients had hypothyroidism and 25% had adrenal hypofunction. Postoperatively, 75% of patients with headache noted improvement, and 33% of patients with abnormal thyroid function had normal function. Adrenal function did not improve. Three patients had an intrasellar cysticercosis cyst, epidermoid cyst, and postoperative cyst, respectively. All had evidence of partial hypopituitarism; none improved postoperatively. The results indicate that different types of pituitary cysts produce different clinical syndromes, and suggest that simple transsphenoidal drainage and partial removal of the cyst wall can provide safe and effective therapy.
 ...
PMID:Transsphenoidal treatment of non-neoplastic intrasellar cysts. A report of 38 cases. 668 30

Sixty-nine pregnancies were observed in 57 hyperprolactinemic women (5 with pituitary macroadenoma, 20 with microadenoma, and 32 with normal tomography of the sella turcica). Ten of these pregnancies took place spontaneously in women with mild to moderate hyperprolactinemia (up to 70 ng/ml); 2 were induced by exogenous gonadotropins, 2 by clomiphene, 42 by bromocriptine, and 9 by metergoline; and 4 occurred after pituitary selective adenomectomy. The observed complications included spontaneous abortion (10 cases); headache (7 cases); sellar enlargement (5 cases); and bitemporal hemianopsia (1 subject with macroadenoma). Among 24 women in whom prolactin levels were reevaluated at least 1 month after parturition and/or lactation, 8 showed a decrease in prolactin concentration (less than 50% of pregestational levels), with actual prolactin normalization in 3 and resumption of cyclic menses in 2 previously amenorrheic women. In contrast, no changes in prolactin levels occurred after pregnancies that ended in abortion. These data suggest the following: 1) conception is not uncommon in women with moderate hyperprolactinemia; and 2) pregnancy may be safely induced without prior surgery and/or radiotherapy in hyperprolactinemic women, except those with large pituitary adenomas, and a considerable number of these patients even show a clinical and biochemical improvement after pregnancy.
 ...
PMID:Spontaneous and induced pregnancies in hyperprolactinemic women. 679 19

We investigated the frequency of headaches in women with menstrual abnormalities and hyperprolactinemia. Twenty-seven of 46 (58%) women with hyperprolactinemia indicated that headache episodes occur once or more per week; patients with sellar abnormalities (macroadenoma) or previous cranial or pituitary operation were excluded from this group of hyperprolactinemic patients. The headache episodes occurred significantly more frequently than in the control group (N = 56), where 27% indicated one or more headaches per week (p less than 0.01). In the vast majority of the women with hyperprolactinemia, headaches had preceded the finding of elevated prolactin levels for years and had not developed after the patients had become concerned about the pituitary gland. The clinical impression was that the headaches of these patients typically lack features of prodromal signs and unilaterality and resemble, in general, tension headaches; they may last for hours and often require medication. We could not demonstrate a relationship between prolactin levels and frequency or severity of these headache episodes. The etiology of these headaches is unclear. The therapeutic effect of bromocriptine deserves further investigation. In conclusion, we present data to suggest that headaches are commonly an associated finding in hyperprolactinemic women who have no evidence of significant pituitary enlargement.
 ...
PMID:Hyperprolactinemia and headaches. 682 53

Fifty-four patients with evidence of a prolactin-producing pituitary microadenoma were followed through pregnancy. Obstetric complications included four spontaneous abortions, one stillbirth, and one premature delivery. Four patients developed visual defects (two with abnormal visual fields). Four patients noted headaches. The progressive rise in maternal prolactin levels seen in a control group was not seen in the prolactinoma patients. In the tumor patients, maternal prolactin levels were already elevated early in pregnancy and did not increase further. Maternal prolactin levels were not predictive of any complications. The present study suggests that pregnancy is safe in microadenoma patients and that the few complications encountered are highly amenable to appropriate management.
 ...
PMID:Prolactin-producing microadenomas in pregnancy. 688 19

Two women evaluated for amenorrhea, galactorrhea, and hyperprolactinemia had radiographic changes of the sella turcica (localized erosion on trispiral tomography) suggestive of a pituitary tumor. Both patients experienced spontaneous regression of apparent prolactin-secreting adenomas with a marked decrease in the quantity of galactorrhea and a reduction of serum prolactin concentrations to the normal range. One patient noted a marked improvement of headaches and spontaneous menses resumed in the other patient.
 ...
PMID:Spontaneous regression of prolactin-producing pituitary adenomas. 718 26

A 28-year-old woman with bilateral headaches and vomiting was found to have normal prolactin levels despite an eight-year history of intermittent galactorrhea and amenorrhea and the current finding of a pituitary microadenoma. The microadenoma contained hemosiderin. It is concluded that pituitary apoplexy is not confined to large tumors that have outgrown their blood supply, but can occur in microadenomas with regression of a positive endocrinopathy.
 ...
PMID:Apoplexy in a prolactin microadenoma leading to remission of galactorrhea and amenorrhea. 719 10

Twenty-eight women with hyperprolactinaemia and amenorrhoea received bromocriptine treatment which resulted in 31 term pregnancies. Bromocriptine treatment was stopped as soon as pregnancy was established. Nineteen of the women had radiological signs of a pituitary tumour. The pregnancies were clinically uneventful in all cases except one who developed headache. Post-partum sellar X-ray showed pregnancy-induced enlargement of the pituitary fossa in 4 of the 28 women. Regression of the radiological changes occurred in 3 of the 4 women within 2 years after the delivery. The women with abnormal sellar X-rays had no difference in the mean prolactin levels before treatment and after pregnancy and lactation while all the women with normal sellae had lower prolactin levels after pregnancy than before. Three women resumed regular spontaneous menstruations after pregnancy and lactation but only one conceived again. Thus, serious pituitary tumour complications are rare in hyperprolactinaemic women with bromocriptine-induced pregnancies. The pregnancy does not worsen the condition. Resolution of hyperprolactinaemia after bromocriptine-induced pregnancy is an unfrequent finding.
 ...
PMID:Effects of bromocriptine-induced pregnancy on prolactin-secreting pituitary tumours. 729 65

The neuroendocrine challenge paradigm provides a "window" on central neurotransmitter function in vivo. This strategy is based on the premise that the sensitivity of certain central receptors can be inferred from the magnitude of the hormonal response to specific pharmacologic probes. For example, the serotonin (5HT) receptor agonist m-chlorophenylpiperazine (m-CPP) stimulates the release of cortisol and prolactin and induces migraine-like headaches. We have previously reported that the headache and cortisol responses to m-CPP are highly correlated, which may implicate a disturbance in central serotonergic neurotransmission in the pathogenesis of migraine. As pharmacologic probes with greater specificity for 5HT receptor subtypes become available, we may be able to elucidate these mechanisms with greater precision. The neuroendocrine challenge methodology is also applicable to the study of other neurotransmitter systems and other headache disorders.
Cephalalgia 1995
PMID:The neuroendocrine challenge paradigm in headache research. 758 26

A 39-year-old male physician with a 27-year history of chronic severe migraine had a prolactin-secreting pituitary microadenoma diagnosed as an incidental finding following an automobile accident. Treatment of the prolactinoma with bromocriptine provided complete and lasting resolution of the migraine as well, suggesting a possible etiologic relationship between these two prevalent conditions, and the possibility of treating at least some cases of migraine with bromocriptine.
Headache
PMID:Resolution of migraine following bromocriptine treatment of a prolactinoma (pituitary microadenoma). 767 63


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>