Skip to main content
NCBI home page
The Journal of Headache and Pain logoLink to The Journal of Headache and Pain
. 2008 Dec 9;10(1):15–20. doi: 10.1007/s10194-008-0084-0

Headache associated with pituitary tumors

Jackson A Gondim 1,✉, João Paulo Cavalcante de Almeida 1, Lucas Alverne Freitas de Albuquerque 1,2, Michele Schops 2, Érika Gomes 1, Tânia Ferraz 1
PMCID: PMC3451766  PMID: 19067118

Abstract

The objective of this study is to analyze the presence of headache in pituitary tumors and their characteristics, the relationship between pituitary tumor size, biological type, local extension and intrasellar pressure (ISP). This is a prospective study, of 64 consecutive patients presenting with primary pituitary masses at Neuroendocrinological Department of General Hospital of Fortaleza from October 2005 to December 2006. We analyzed sex, age, headache (laterality, site, severity, quality, frequency, duration, associated symptoms, time of onset, trigger, alleviating factors and familial history) and tumor characteristics (type, size, quiasmatic compression, cavernous sinus invasion, sella turcica destruction, cystic or solid mass and ISP). We observed a statistic significant factor between pituitary tumor and tumor size, optic compression, sellar destruction, cavernous sinus invasion and ISP. Biochemical-neuroendocrine factors, mainly in prolactinomas, seem to be an important factor in the determination of headache. The presence of headache in pituitary tumor is related to a combination of factors, including ISP, tumor extension, relationship with the sellar structures, patient predisposition, familial history, and functional disturbance within the hypothalamo-pituitary axis.

Keywords: Headache, Intrasellar pressure, Pituitary adenoma

Full Text

The Full Text of this article is available as a PDF (166.1 KB).

Conflict of interest

None.

References

  • 1.Suwanwela N, Phanthumchinda K, Kaoropthum S. Headache in brain tumor: a cross-sectional study. Headache. 1994;34:435–438. doi: 10.1111/j.1526-4610.1994.hed3407435.x. [DOI] [PubMed] [Google Scholar]
  • 2.Yokoyama S, Mamitsuka K, Tokimura H, Asakura T. Headache in pituitary adenoma cases. J Jpn Soc study Chron Pain. 1994;13:79–82. [Google Scholar]
  • 3.Forsyth PA, Posner JB. Headaches in patients with brain tumors: a study of 111 patients. Neurology. 1993;43:1678–1683. doi: 10.1212/wnl.43.9.1678. [DOI] [PubMed] [Google Scholar]
  • 4.McNaughton FL. The innervation of the intracranial blood vessels and dural sinuses. Proc Assoc Res Nervous Mental Dis. 1938;18:178–200. [Google Scholar]
  • 5.Cottier JP, Destrieux C, Brunereau L, Berrand P, Moreau L, Jan M, Herbreteau D. Cavernous sinus invasion by pituitary adenoma: MR imaging. Radiology. 2000;215:463–469. doi: 10.1148/radiology.215.2.r00ap18463. [DOI] [PubMed] [Google Scholar]
  • 6.Hennessey JV, Jackson IM. Clinical features and differential diagnosis of pituitary tumours with emphasis on acromegaly. Baillieres Clin Endocrinol Metab. 1995;9:271–314. doi: 10.1016/S0950-351X(95)80338-6. [DOI] [PubMed] [Google Scholar]
  • 7.Porta-Etessam J, Ramos-Carrasco A, Berbel-Garcia A, Martinez-Salio A, Benito-Leon J. Clusterlike headache as first manifestation of a prolactinoma. Headache. 2001;41:723–725. doi: 10.1046/j.1526-4610.2001.041007723.x. [DOI] [PubMed] [Google Scholar]
  • 8.Pascual J, Freijares J, Berciano J, Pesquera C. Analgesic effect of octreotide in headache associated with acromegaly is not mediated by opioid mechanisms. Pain. 1991;47:341–344. doi: 10.1016/0304-3959(91)90226-N. [DOI] [PubMed] [Google Scholar]
  • 9.Gondim JA, Tella OI, Schops M. Intrasellar pressure and tumor volume in pituitary tumor: relation study. Arq Neuropsiquiatr. 2006;64:971–975. doi: 10.1590/s0004-282x2006000600016. [DOI] [PubMed] [Google Scholar]
  • 10.Lundin P, Pedersen F. Volume of pituitary macroadenomas: assessment by MRI. J Comput Assisted Tomogr. 1992;16:519–528. doi: 10.1097/00004728-199207000-00004. [DOI] [PubMed] [Google Scholar]
  • 11.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. doi: 10.1001/archneur.61.5.721. [DOI] [PubMed] [Google Scholar]
  • 12.Headache Classification Committee of The International Society Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalagia. 1988;8:1–96. doi: 10.1046/j.1468-2982.1988.0801001.x. [DOI] [PubMed] [Google Scholar]
  • 13.Headache Classification Committee of The International Society The international classification of headache disorders (2nd edn) Cephalagia. 2004;24:1–160. [Google Scholar]
  • 14.Lipton RB, Stewart WF, Diamond S, Diamond ML, Reed M. Prevalence and burden of migraine in the United States: data from the American Migraine Study II. Headache. 2001;41:646–657. doi: 10.1046/j.1526-4610.2001.041007646.x. [DOI] [PubMed] [Google Scholar]
  • 15.Steiner TJ, Scher AI, Stewart WF, Kolodner K, Liberman J, Lipton RB. The prevalence and disability burden of adult migraine in England and their relationships to age, gender and ethnicity. Cephalalgia. 2003;23:519–527. doi: 10.1046/j.1468-2982.2003.00568.x. [DOI] [PubMed] [Google Scholar]
  • 16.Millan Guerrero RO, Isais Cardenas MA. Headache associated with pituitary adenomas. Headache. 1999;39:522–523. doi: 10.1046/j.1526-4610.1999.3908576.x. [DOI] [PubMed] [Google Scholar]
  • 17.Abe T, Matsumoto K, Kuwazawa J, Toyoda I, Sasaki K. Headache associated with pituitary adenomas. Headache. 1998;38:782–786. doi: 10.1046/j.1526-4610.1998.3810782.x. [DOI] [PubMed] [Google Scholar]
  • 18.Levy MJ, Matharu MS, Meeran K, Powell M, Goadsby PJ. The clinical characteristics of headache in patients with pituitary tumours. Brain. 2005;128:1921–1930. doi: 10.1093/brain/awh525. [DOI] [PubMed] [Google Scholar]
  • 19.Silbertein SD, Lipton RB. Chronic dally headache. Curr Opin Neurol. 2000;13:277–283. doi: 10.1097/00019052-200006000-00008. [DOI] [PubMed] [Google Scholar]
  • 20.Massiou H, Launay JM, Levy C, El Amran M, Emperauger B, Bousser M-G. SUNCT syndrome in two patients with prolactinomas and bromocriptine-induced attacks. Neurology. 2002;58:1698–1699. doi: 10.1212/wnl.58.11.1698. [DOI] [PubMed] [Google Scholar]
  • 21.Welch KMA, Goadsby PJ. Chronic daily headache: nosology and pathophysiology. Curr Opin Neurol. 2002;15:287–295. doi: 10.1097/00019052-200206000-00011. [DOI] [PubMed] [Google Scholar]
  • 22.Williams G, Ball JA, Lawson RA, Joplin GF, Bloom SR, Maskill MR. Analgesic effect of somatostatin analogue (octreotide) in headache associated with pituitary tumours. BMJ. 1987;295:247–248. doi: 10.1136/bmj.295.6592.247. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 23.Gabrielli M, Gasbarrini A, Fiore G, et al. Resolution of migraine with aura after successful treatment of a pituitary microadenoma. Cephalalgia. 2002;22:149–150. doi: 10.1046/j.1468-2982.2002.00314.x. [DOI] [PubMed] [Google Scholar]
  • 24.Hartman N, Voron SC, Hershman JM. Resolution of migraine following bromocriptine treatment of a prolactinoma (pituitary microadenoma) Headache. 1995;35:430–431. doi: 10.1111/j.1526-4610.1995.hed3507430.x. [DOI] [PubMed] [Google Scholar]
  • 25.Levy MJ, Matharu MS, Goadsby PJ. Prolactinomas, dopamine agonist and headache: two case reports. Eur J Neurol. 2003;10:169–174. doi: 10.1046/j.1468-1331.2003.00549.x. [DOI] [PubMed] [Google Scholar]
  • 26.Ferrari MD, Haan J, Seters AP. Bromocriptine-induced trigeminal neuralgia attacks in a patient with pituitary tumor. Neurology. 1988;38:1482–1484. doi: 10.1212/wnl.38.9.1482. [DOI] [PubMed] [Google Scholar]
  • 27.Gondim JA, Schops M, Tella OI. Transnasal endoscopic surgery of the sellar region: study of the first 100 cases. Arq Neuro Psiquiatr. 2003;61:836–841. doi: 10.1590/s0004-282x2003000500024. [DOI] [PubMed] [Google Scholar]
  • 28.Arafah BN, Prunty D, Ybarra J, Hlavin ML, Selman WR. The dominant role of increased intrasellar pressure in the pathogenesis of hypopituitarism, hyperprolactinemia, and headaches in patients with pituitary adenomas. J Clin Endocrinol Metabol. 2000;85:1789–1793. doi: 10.1210/jc.85.5.1789. [DOI] [PubMed] [Google Scholar]

Articles from The Journal of Headache and Pain are provided here courtesy of BMC

RESOURCES