Is There an Association Between Pituitary Adenomas and Autonomic Cephalgia?

Year 2019, Volume: 5 Issue: 3, 267 - 272, 31.12.2019

Şükran Kaygısız Özlem Coşkun Serap Üçler Levent Ertuğrul İnan Burç Esra Şahin

https://doi.org/10.19127/mbsjohs.554125

Abstract

Objective:
Trigeminal autonomic cephalalgias (TACs) are a group of primary headache
syndromes. Although hemicrania continua (HC)is not included among the TACs
according to the International Classification of Headache Disorders (ICHD-II),
it also shows autonomic symptoms. In the literature, some authors suggest that
TACs can be related with pituitary lesions. In this study, we have compared the
pituitary lesions observed in the TAC, HC and migraine-type headache patients

Methods
The cranial magnetic resonance images (MRI) of the
patients with TAC, HC and migraine without aura (MWOA) unaccompanied by
autonomic symptoms were retrospectively evaluated. The 33 TAC and HC patients
were compared with the 30 migraine without aura (MWOA) patients.

Results:
The mean age of the TAC and HC patients was 43. 36±10. 72
years, whereas the mean age of the MWOA patients was 39.0±6.92 years. No
statistically significant difference in terms of age was observed between the
groups (p˃0.05). The MRI of the TACs and HC patients indicated that 62.5%
(n:20) were normal, while 12.5% (n:4) had pituitary microadenomas, 6.3 % (n:2)
had macroadenomas, 12.5% (n:4) had suspected pituitary microadenomas, and 6. 3%
(n:2) had suspected heterogeneity. The MRI results of the MWOA patients were normal
in 46.7% (n:14), whereas 23.3% (n:7) had pituitary microadenomas, 23.3% (n:7)
had suspected pituitary microadenomas, and 6. 2% (n:2) had suspected pituitary
heterogeneity. No statistically significant difference was observed between
both groups (p>0. 05).

Conclusion:
In this study, no correlation was observed between the TACs,
HC and pituitary abnormalities. In conclusion, the use of pituitary MRI has not
been supported as a routine method in patients with this type of headache

Keywords

Hypophysis, Headache, Pituitary

References

• Abe T, Matsumoto K, Kuwazawa J, Kuwazawa J, Toyoda I, Sasaki K .Headache associated with pituitary adenomas.Headache 1998;38:782 – 86.
• Baykan B, Idrisoğlu HA. Headache .Oge AE, Baykan B, editor. Headache. İstanbul: Neurology Second edition. Nobel Medical Bookstores; 2011. P.373-94.
• Chinar O, AnishB. Paroxysmal Hemicrania.Ann Indian Acad Neurol. 2018; 21:16–S22.
• Dora B. New Horizons in Neurology.İnan L, editor. Other Trigeminal Autonomic Cephalgias. Ankara: First edition; Gunes Medical Bookstores; 2011.p.97 -114.
• Elisabetta C, Manjit S. M. Symptomatic Trigeminal Autonomic Cephalalgias. The Neurologist.2009; 15: 305 -312.
• Inan LE. New Horizons in Neurology.İnan L E, editor. General Approach to Headache Patient. Ankara: First edition; Gunes Medical Bookstores; 2011.p.1-13. Jacson A. G, Joao Paulo Cavalcante de Almeida, Lucas Alverne Freitas de Albuquerque, Michele Schops, Erika Gomes, Tania Ferraz. Headache associated with pituitary tumors. J Headache Pain.2009;10: 15 – 20.
• Levy MJ, Jager HR, Powell M, Matharu MS, Meeran K, Goadsby PJ. Pituitary volume and headache: size is not everything. Arch Neurol.2004; 61: 721 – 725.
• Matharu M, Godsby P. Trigeminal autonomic cephalalgias: diagnosis and management. In: Silberstein S, Lipton R, Dodick D, eds. Wolff’s Headache and Other Head Pain. 8th ed. New York, NY: Oxford University Press. 2007; 379 – 430
• Olesen J. Headache Classification Committee of the International Headache Society.Classification of the Headache Disorders 2. Edition. Cephalagia.2004; 24; Sup.1: 1-156.
• Ozturk V. New Horizons in Neurology. Inan LE, editor. Cluster headache. Ankara: First edition; Gunes Medical Bookstores; 2011.p.81-96.
• Saip S. New Horizons in Neurology. Inan LE, editor. Classification of headache disorders. Ankara: First edition; Gunes Medical Bookstores; 2011.p.15-32.
• Shuu- Jiun W, Chia-Wei H, Jong-Ling F, Jiing- Feng L, Chii-Min H. Cranial Autonomic Symptoms in Patients with Pituitary Adenoma Presenting with Headaches. Acta Neurologica Taiwanica. 2009;18: 104 – 112.
• Uluduz D, Ayta S, Cranial Autonomic Features in Migraine and Migrainous Features in Cluster Headache. Noro Psikiyatr Ars. 2016;3:220-224
• Wang SJ, Hung CW, Fuh JL, Lirng JF, Hwu CM. Cranial autonomic symptoms in patients with pituitary adenoma presenting with headaches. Acta Neurol Taiwan.2009;18(2):104-12.
• Williams G, Ball JA, Lawson RA, Joplin GF, Bloom SR, Maskill MR. Analgesic effect of somatostatin analogue (octreotide) in headache associated with pituitary tumours. BJM.1987; 295: 247 -248.