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Is pituitary MRI screening necessary in cluster headache?
Lou Grangeon1,2, Emer O'Connor1, Daisuke Danno1
1Headache and Facial Pain Group, UCL Queen Square Institute of Neurology, Queen Square, London, UK.
Cephalalgia : an International Journal of Headache
|January 7, 2021
Summary
Pituitary adenomas are not more common in cluster headache patients than in the general population. Routine pituitary screening is not necessary for cluster headache diagnosis, only for patients with specific symptoms or imaging findings.
Area of Science:
- Neurology
- Endocrinology
- Radiology
Background:
- Cluster headache is a debilitating neurological disorder.
- Pituitary adenomas are tumors that can cause various symptoms.
- The relationship between cluster headache and pituitary adenomas requires clarification.
Purpose of the Study:
- To determine the prevalence of pituitary adenomas in cluster headache patients.
- To identify clinical predictors of pituitary adenomas in this cohort.
- To assess the necessity of dedicated pituitary MRI in cluster headache management.
Main Methods:
- Retrospective study of 718 cluster headache patients.
- Analysis of brain MRI scans (standard and dedicated pituitary views) from 2007-2017.
- Inclusion of demographic, clinical, treatment, and imaging data.
Main Results:
- Pituitary adenomas found in 4.52% (17/376) of patients with dedicated pituitary MRI.
- Non-functioning microadenomas were most common.
- No clinical predictors for adenomas were identified; systematic screening did not benefit patients.
Conclusions:
- The prevalence of pituitary adenomas in cluster headache patients is similar to the general population.
- Specific pituitary screening is not recommended for all cluster headache patients.
- MRI with dedicated pituitary views is only indicated for patients with suggestive symptoms or standard MRI findings.
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