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Migrainelike Headache in a Patient With a Hemorrhagic Pituitary Macroadenoma
Author(s) -
Evans Randolph W.
Publication year - 1997
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1046/j.1526-4610.1997.3707455.x
Subject(s) - medicine , pituitary apoplexy , pituitary adenoma , ketorolac , differential diagnosis , radiology , subarachnoid hemorrhage , mri scan , pituitary gland , pituitary tumors , magnetic resonance imaging , surgery , anesthesia , adenoma , pathology , analgesic , hormone
A 23‐year‐old woman presented with a 4‐day history of a severe migrainelike headache with a normal neurologica examination. The headache resolved after a ketorolac injection, but recurred a few hours later. An MRI scan of the brain showed a hemorrhagic pituitary macroadenoma for which she underwent transsphenoidal removal of the tumor 1 month later. Although uncommon, pituitary hemorrhage with and without apoplexy should be considered in the differential diagnosis of acute headache. Pituitary hemorrhage can be routinely identified on an MRI scan even without pituitary views. However, the pathology can be overlooked and underimaged on a CT scan for acute headache using 10‐mm and even 5‐mm slices.