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Presentation and Management of Headache in Pituitary Apoplexy. [Review]

MedStar author(s):

Citation: Current Pain & Headache Reports. 23(9):61, 2019 Jul 29.PMID: 31359174Institution: MedStar Washington Hospital CenterDepartment: NeurologyForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: *Disease Management | *Headache/dg [Diagnostic Imaging] | *Headache/th [Therapy] | *Pituitary Apoplexy/dg [Diagnostic Imaging] | *Pituitary Apoplexy/th [Therapy] | Aged, 80 and over | Anti-Inflammatory Agents, Non-Steroidal/ad [Administration & Dosage] | Headache/et [Etiology] | Humans | Magnetic Resonance Imaging/mt [Methods] | Male | Neurosurgical Procedures/mt [Methods] | Pituitary Apoplexy/co [Complications] | Young AdultYear: 2019 ISSN:

1534-3081

Name of journal: Current pain and headache reportsAbstract: PURPOSE OF REVIEW: Pituitary apoplexy (PA) occurs in the setting of an infarction and/or hemorrhage of a pre-existing adenoma. The most common presenting symptom is a severe, sudden onset headache. However, the characteristics of headache in the setting of PA are varied and can sometimes mimic primary headache disorders. The purpose of this article is to review the various presentations of headache in PA. We also outline treatment options for persistent headaches following PA.RECENT FINDINGS: A recent retrospective review of patients undergoing transsphenoidal resection of sellar lesions, including PA, found that gross total resection and short duration of preoperative headache were predictors of improvement in headaches postoperatively. This strengthens the importance of timely recognition of PA as potential etiology of headache. The most common presentation of PA is thunderclap headache; however, several other primary HA disorders have been described including status migraine, SUNCT, and paroxysmal hemicrania.All authors: Dougherty C, Suri HFiscal year: FY2020Digital Object Identifier:

https://dx.doi.org/10.1007/s11916-019-0798-5

Date added to catalog: 2019-08-23

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Title notes ( 3 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	31359174	Available		31359174

PURPOSE OF REVIEW: Pituitary apoplexy (PA) occurs in the setting of an infarction and/or hemorrhage of a pre-existing adenoma. The most common presenting symptom is a severe, sudden onset headache. However, the characteristics of headache in the setting of PA are varied and can sometimes mimic primary headache disorders. The purpose of this article is to review the various presentations of headache in PA. We also outline treatment options for persistent headaches following PA.

RECENT FINDINGS: A recent retrospective review of patients undergoing transsphenoidal resection of sellar lesions, including PA, found that gross total resection and short duration of preoperative headache were predictors of improvement in headaches postoperatively. This strengthens the importance of timely recognition of PA as potential etiology of headache. The most common presentation of PA is thunderclap headache; however, several other primary HA disorders have been described including status migraine, SUNCT, and paroxysmal hemicrania.

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