Intermittent headache

Introduction Intermittent headache is one of the clinical manifestations of nonfunctioning pituitary adenomas. Headache is one of the most common symptoms in the clinic. It is usually limited to the upper part of the skull, including the eyebrow arch, the upper edge of the ear wheel and the pain above the occipital kyphosis. There are many reasons for headaches, some of which are serious fatal diseases, but the diagnosis of the cause is often difficult. Attenuated effects of hypothalamic repressors may also contribute to tumorigenesis. In patients with adrenal Cushing syndrome, after negative adrenalectomy, the negative feedback inhibition of cortisol on CRH secretion in the hypothalamus is weakened, CRH secretion is increased, and ACTH adenoma is rapidly developed in patients.

Cause

Causes

Non-functional pituitary adenomas are actually a group of heterogeneous tumors, most of which have a dividing function (mostly gonadotropins), but their secretion function is low, does not cause an increase in blood levels, such tumors It is called silent adenoma. Some non-functional adenomas may indeed have no secretory function and their cell sources are unclear.

an examination

Related inspection

EEG examination of brain CT

(1) Headache: Patients found in 1/3 to 2/3 are not very intense at the beginning, mainly suffering from pain, and may be intermittently aggravated. The headache area is mostly in the two ankles, the forehead, the back of the eyeball or the base of the nose. The main cause of headache is that the saddle and the surrounding dura mater are pulled due to the upward growth of the tumor. When the tumor breaks through the saddle, the pain can be alleviated or disappeared.

(2) oppression of the optic nerve pathway: pituitary adenoma spread to the saddle, oppression of the optic chiasm can cause different types of visual field defects with or without vision loss. This is due to the different directions of tumor growth and the variation of the anatomical relationship between the optic chiasm and the pituitary gland.

Differential diagnosis

Differential diagnosis:

1, recurrent headache: is one of the most common clinical symptoms, usually refers to the upper part of the skull, including the eyebrow arch, the upper edge of the ear wheel and the occipital bulge above the line of pain.

2, intractable headache: symptoms of persistent headache for many years.

3, chronic headache: referred to as CHD, refers to frequent headaches more than 15 days a month, headaches lasting more than 4 hours a day.

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