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Headaches Associated with Rathke's Cleft Cyst
Author(s) -
Nishioka Hiroshi,
Haraoka Jo,
Izawa Hitoshi,
Ikeda Yukio
Publication year - 2006
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 - 10.1111/j.1526-4610.2006.00539.x
Subject(s) - headaches , medicine , craniopharyngioma , dermatology , surgery
Objective.—Headaches are common presentations in patients with Rathke's cleft cyst (RCC). This study was conducted to elucidate the characteristics and underlying mechanisms of the headache. Methods.—We retrospectively studied 46 patients with RCC, 33 of whom underwent surgical intervention. Results.—Headache, particularly frontal headache, was the most common symptom, occurring in 27 patients (58.7%). Eleven patients with sudden episodic headache mimicking that of pituitary apoplexy. Although the presence of headache did not correlate with cyst size, it was significantly more common in RCCs with: high‐ and iso intensity content on T1‐weighted MR image ( P = .0363), mucous content within the cyst ( P = .0023), and intense chronic inflammation at the cyst wall ( P = .0276). Among 6 patients with histologically recognized intense inflammation, every patient had frontal headache ( P = .0407), 5 patients had episodic headache ( P = .0002), and 4 patients had associated hypopituitarism ( P = .0073), none of which improved after surgical intervention. Headaches improved after surgery in 17 of 21 patients (81.0%). Conclusions.—Headache, particularly frontal episodic headache, is a common and characteristic manifestation in patients with RCC and may indicate intermittent inflammatory reactions caused by mucous content. Patients with episodic headache should undergo surgical treatment to prevent exacerbation of the inflammation that can result in irreversible endocrine dysfunction.