Headache in patients with pituitary adenoma: Clinical and paraclinical findings

Schankin, Christoph J.; Reifferscheid, Anna K.; Krumbholz, Markus; Linn, Jennifer; Rachinger, Walter; Langer, Sigrid; Sostak, Petra; Arzberger, Thomas; Kretzschmar, Hans; Straube, Andreas

doi:10.1177/0333102412462639

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Headache in patients with pituitary adenoma: Clinical and paraclinical findings

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Krumbholz, Markus
Department: Neuroimmunology / Wekerle, MPI of Neurobiology, Max Planck Society;

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Schankin, C. J., Reifferscheid, A. K., Krumbholz, M., Linn, J., Rachinger, W., Langer, S., Sostak, P., Arzberger, T., Kretzschmar, H., & Straube, A. (2012). Headache in patients with pituitary adenoma: Clinical and paraclinical findings. Cephalalgia, 32(16), 1198-1207. doi:10.1177/0333102412462639.

引用: https://hdl.handle.net/11858/00-001M-0000-000E-7671-A

要旨

Aim: The aim of this article is to generate hypotheses for the mechanism of pituitary adenoma headache.
Patients and methods: Fifty-eight patients with pituitary adenoma were prospectively analysed for prevalence and manifestation of tumour headache. Intrapersonal and neoplasm-associated risk factors were assessed.
Results: Twenty-four patients (41%) had tumour-attributed headache, seven had migraine-like, 11 tension-type headache-like headache, and three both. Cluster headache-like headache was found once, and two headaches remained unclassified. Tumour-attributed headache was associated with a positive history of headache (p = 0.03; OR 3.4), nicotine abuse (p<0.01; OR 4.7), intake of acute headache medication (p = 0.04; OR 3.3), and a higher tumour proliferation indicated by a Ki67-labelling index (LI) >3% (p = 0.02; OR 11.0). For patients with migraine-like tumour-attributed headache, risk factors were younger age (p = 0.02), nicotine abuse (p<0.01; OR 10.9), acute headache treatment (p<0.01; OR 9.0), and Ki67-LI >3% (p = 0.03; OR 14.1). For tension-type headache-like headache, the main risk factor was a positive history of tension-type headache (p = 0.045; OR 5.6).
Conclusion: Headache predisposition and local tumour effects might be important for the pathophysiology of pituitary adenoma headache and tumour headache in general.