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Pituitary volume and headache: size is not everything
Miles J Levy1, H Rolf Jäger, Michael Powell
1Headache Group and the Department of Radiology, Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, England.
Archives of Neurology
|May 19, 2004
Summary
Pituitary tumor headaches are common, but tumor size and cavernous sinus invasion are not the primary causes. A family history of headaches is strongly linked to pituitary tumor-associated headaches.
Area of Science:
- Endocrinology
- Neurology
- Oncology
Background:
- Pituitary tumors frequently cause debilitating headaches.
- Current understanding attributes these headaches to dural stretch or cavernous sinus invasion.
Purpose of the Study:
- To investigate the relationship between pituitary tumor size and headache occurrence.
- To explore potential correlations between tumor characteristics and headache severity.
Main Methods:
- Prospective study of 63 patients with newly diagnosed pituitary tumors.
- Assessment of clinical headache scores, pituitary tumor volume, and cavernous sinus invasion.
- Statistical analysis using Spearman rank correlation and chi-squared test.
Main Results:
- Headache prevalence was 70% among patients with pituitary tumors.
- No significant correlation was found between pituitary tumor volume and headache score (r = -0.32, P =.01).
- Cavernous sinus invasion did not correlate with headache presence.
- A strong association exists between pituitary tumor headache and a family history of headache (chi(2) = 8.36, P =.004).
Conclusions:
- Pituitary tumor-associated headache is likely multifactorial, not solely structural.
- Family history and potential endocrine activity of the tumor are significant factors.
- Further research into these mechanisms is crucial for effective patient treatment and understanding headache syndromes.