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

The presenting signs, symptoms, roentgenographic findings, endocrine evaluations, treatment, and results in 68 cases of presumed pituitary adenomas treated over an 18-year period are discussed. The most common symptoms were headache, acromegalic changes, visual symptoms, and amenorrhea. Most common physical findings were obesity, acromegaly, and visual field defects, usually bitemporal hemianopsia. Roentgenographic evidence of sellar erosion was almost universal but angiography and pneumoencephalography were required to evaluate suprasellar extension. Brain scan was not considered a particularly useful diagnostic tool. Endocrine status was best evaluated by a battery of tests including 17-OH, 17-KS, T3, T4, PBI, ACTH stimulation, and FSH and STH levels. (Prolactin levels are currently being obtained, also). Surgical specimens were obtained in 29 patients, with subsequent diagnoses of 22 chromophobe adenomas, five eosinophilie adenomas, one cystic adenoma, and one necrotic tumor. All five eosinophilic tumors came from acromegalic patients. Patients treated by operation alone or operation followed by radiotherapy generally had less "medical morbidity" than did patients who received radiotherapy alone.
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PMID:Review of 18 years' experience with pituitary tumors. 19 48

Among 135 consecutive cases of hypopituitary dwarfism, 42 related to detectable intracranial tumour or defect. In 13 cases the tumour had been previously operated and/or irradiated. In 29 others the defect was suggested by neurological abnormalities or headache, skull radiographs, ocular examination or by associated post-hypophyseal deficiency and was demonstrated by pneumoencephalography. When none of these associated abnormalities was found, pneumoencephalography failed to demonstrate any intracranial lesion. Among the 93 so-called idiopathic cases there was a large majority of males (60/93) with a history of birth difficulties (34/60) and especially of breech delivery (23/60). TSH, FSH/LH and ACTH deficiencies were associated to GH deficiency in 81% of patients with detectable intracranial lesions, 57% of male and 39% of female idiopathic cases. The number of patients with idiopathic isolated GH deficiency was similar in boys and girls, suggesting in them the hypothesis of a recessive autosomic genetic defect in spite of the scarcity of familial cases. Peculiar clinical associations may contribute to the diagnosis.
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PMID:[Etiology and associations of pituitary dwarfism. Study of a series of 135 cases]. 20 86

Of 300 menopausal patients, 82 experienced climacteric symptoms, with vasomotor disturbances absent in 42 (Group 1) and present in 40(Group 2). Group 2 patients commonly complained of headaches, insomnia and dyspareunia, while Group 1 complained mostly of loss of libido and depression. Group 2 was managed rather successfully with treatment of conjugated equine estrogens (Premarin) daily for 3 weeks; Group 1 was given the same treatment but the response was disappointing. Women with vasomotor symptoms exhibited a lower, mean plasma estradiol concentration compared with that observed during days 1-10 of the menstrual cycle. Concenerations of FSH (Plasma follicle stimulating hormone) and LH (luteinizing hormone) in women with vasomotor symptoms were similar to those of younger, regularly menstruating women. Group 2 patients treated for 6 months with estrogen had a 2.1 fold increase in mean plasma estradiol concentration and 39% and 66% reduction of pretreatment plasma FSH and LH concentrations, respectively; Group 1 did not exhibit such changes. Patients with estrogen-responsive symptoms exhibited high concentrations of FSH (15 U/1 was the diagnostic cut-off point). Effective patient selection for estrogen replacement therapy can be achieved by using this measurement in the presence of characteristic symptoms.
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PMID:Relation between plasma hormone profiles, symptoms, and response to oestrogen treatment in women approaching the menopause. 21 37

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

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

Effect of extracorporeal UV irradiation of the blood on the clinical picture and hormonal profile of patients with the polycystic ovaries syndrome was under study. 119 women were administered 582 sessions, and in 54 of these the results were followed up for 1-25 months. A good clinical effect was achieved in 88.9% of these cases, it consisted in recovery of the cycle rhythm (70.7%), pregnancy (29.2%), reduction of hirsutism manifestations (19.04%), decrease of galactorrhea (41.7%), cessation or alleviation of headaches (86.2%), body mass reduction (40%), arterial pressure normalization (43.8%). Well-being of the majority of women was improved by therapy. 17-ketosteroids excretion normalized and persisted normal in a month after the treatment. Blood LH level and the LH/FSH ratio significantly reduced in those in whom these values were elevated in disease. Elimination of hyperandrogenism and a trend to normalization of gonadotropin secretion, resulting from extracorporeal UV irradiation of the blood, indicate that such treatment modality is pathogenetically grounded and justify its use in the treatment of women with the polycystic ovaries syndrome.
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PMID:[UV-irradiation of the blood in the treatment of polycystic ovary syndrome]. 130 41

The performance of a new low-dose oral contraceptive (Mercilon) containing only 20 micrograms ethinyloestradiol combined with 150 micrograms desogestrel is reviewed. Eight multicentre clinical trials have been completed and provide information on 10,672 women studied over 73,477 cycles. The high efficacy of Mercilon was indicated by the finding that only 10 pregnancies were reported; nine of these occurred in women who omitted to take Mercilon on a number of days and only one in a woman who took all the tablets according to instructions. Cycle control was good; as with all oral contraceptives, the incidence of breakthrough bleeding and spotting was highest in the first treatment cycle and by the sixth treatment cycle the values were usually < 5% and < 7%. More than 80% of women had regular cycles. Side effects were few, the most common being headache, nausea and breast tenderness with incidences in the sixth treatment cycle of less than 2%, 6% and 6%, respectively. There were no significant changes in body weight or blood pressure. Pharmacodynamic investigations showed no adverse effects. Only 1 of 5 studies found an increased response to a glucose tolerance test compared to the pretreatment test. In 8 of 10 studies, serum HDL-C concentrations increased on treatment and this was associated with increases in apoproteins A1 and A2. Serum triglyceride levels also increased but no change occurred in serum cholesterol or LDL-C levels. Haematological factors were assessed in 8 studies and only minor changes were observed. Serum binding protein (SHBG, CBG, caeruloplasmin) concentrations increased and serum androgen levels decreased. Measurements of blood FSH, LH, oestradiol and progesterone indicated adequate inhibition of ovulation. Mercilon is the only oral contraceptive containing 20 micrograms ethinyloestradiol to have high efficacy, to have no adverse pharmacodynamic effects and, importantly, to produce an acceptable bleeding pattern not significantly different from that of oral contraceptives with a higher content of ethinyloestradiol.
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PMID:Clinical experience and pharmacological effects of an oral contraceptive containing 20 micrograms oestrogen. 145 94

Some pituitary hormones secrete hormones while others do not. Nonsecreting tumors can interfere with normal pituitary hormone secretion and produce tumor symptoms and signs like headaches and visual field defects. The most frequent hormone-secreting tumors are prolactinomas. Growth hormone or ACTH or gonadotropin or gonadotropin-alpha and beta chain-producing tumors are less frequent, TSH producing tumors are extremely rare. The most important elements of the diagnostic work-up are clinical signs and symptoms, assessment of pituitary function (measurement of TSH, free T4, LH, FSH, oestradiol/free testosteron, growth hormone, IGF-1, prolactin, ACTH, Cortisol, serum and urine osmolality), CT and/or MRI and, in patients with large tumors, a visual field exam. The treatment of choice of pituitary tumors is often surgery. Alternative therapies are radiation treatment (in nonoperable patients or when hormone levels are persistently elevated after pituitary surgery) and drug treatment (dopamine agonists in hyperprolactinemia, somatostatin analogues in acromegaly). Pituitary hormone deficiencies are treated depending on the specific deficiency with thyroxine, cortisone, oestrogen/gestagen/testosterone gonadotropines or ADH analogues.
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PMID:[Hypophyseal dysfunction and tumors]. 158 68

The goal pursued has been to analyze clinical observations and hormonal studies of patients with empty sella turcica (EST), in order to review this disorder and determine if it can be considered a real syndrome. Fifteen patients with EST (3 men and 12 women) and mean age of 45.6 +/- 17.9 years have been prospectively studied. In the hypothalamus-hypophysis study, reserves of thyrotropin (TSH), prolactin (PRL), gonadotropins (FSH and LH), growth hormone (GH), adrenocorticotropin (ACTH) and cortisol were assessed. In addition, thyroid hormones and, for men, testosterone, were determined. The pathogenic mechanism was explained in two cases (13.3%). We registered headache in 10 patients, obesity in 8, arterial hypertension in 2 and diabetes mellitus in 2. Multiparity antecedent was found in 2 cases. The hormonal study was abnormal in two cases (40%). Most common abnormalities were hyperprolactinemia (3 cases), deficit of gonadotropins (3 cases), without coexisting both of them in any case, and deficit of GH (2 cases). EST is frequently associated with endocrine disfunction, although clinical implications are rare. The absence of common clinical manifestations in most cases questions the EST as a real syndrome.
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PMID:[Primary empty sella turcica: clinical aspects and hormonal study of 15 cases]. 179 Feb 77

In view of the considerable debate concerning the possible failure of contraception in women taking broad spectrum antibiotics, the authors examined a group of 12 women ages 22-32 in a controlled study. Each had been on longterm therapy with oral contraceptives (OCs) containing ethinyl estradiol (EE) and levonorgestrel (Ng) for at least 6 months and all were in good general health. Blood samples were taken about 11.0 hours after dosing with OCs on days 5, 6, 7, and 8 of their contraceptive cycle, for measurement of EE2, Ng, FSH, and LH by radioimmunoassay. In addition, blood samples were taken on days 19, 20, and 21 of their contraceptive cycle for assay of progesterone concentrations in plasma. The study was repeated in the next cycle of OC use during which the patients took temafloxacin, a broad spectrum quinoline antibiotic in a dose of 600 mg twice daily for 7 days, beginning on day 1 of the cycle. All women completed the study satisfactorily as judged by diary cards, tablet counts, and plasma temafloxacin concentrations. In the early part of the study, some nausea and headaches were experienced; this was due to the taking of the drug on an empty stomach. When the antibiotic was administered with food, this problem was no longer a concern. There was no evidence of any interaction between temafloxacin and OCs. The plasma concentration of EE2 was 61.4 +or- 21.2 pg/ml in the control cycle and 68.5 +or- 26.6 pg/ml in the temafloxacin cycle. The plasma progesterone concentration was 0.53 +or- 0.1 ng/ml in the control cycle and 0.6 +or- 0.24 ng/ml in the temafloxacin cycle (p0.01). No woman demonstrated any significant rise in plasma FSH or LH concentrations during temafloxacin therapy. The authors conclude that there is no evidence for a systematic interaction between temafloxacin and OCs and that there is no need for use of alternative contraceptive methods in women taking OCs who are also being treated with temafloxacin.
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PMID:The lack of interaction between temafloxacin and combined oral contraceptive steroids. 190 91


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