Department of Clinical Neurosciences, University of Calgary and Alberta Health Services, Canada.
Cephalalgia. 2013 Feb;33(3):160-70. doi: 10.1177/0333102412468672. Epub 2012 Nov 29.
Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) are rare types of trigeminal autonomic cephalalgias (TACs). Objective To describe a series of patients with SUNCT and SUNA including relationship to pituitary tumors.
All patients diagnosed with SUNCT or SUNA in the Calgary Headache Assessment and Management Program were reviewed.
Six patients (five SUNCTs and one SUNA) were identified. The pain was severe, sharp, showed fixed-laterality, involved mainly the orbito-fronto-temporal region and was associated with autonomic symptoms. Attack duration ranged from 3 to 300 seconds and frequency was 1-200 paroxysms/day. MRI showed ipsilateral pituitary adenomas to the pain in five out of five of the SUNCT patients. Patients with adenomas underwent surgery. Pathology included three prolactinomas, and one mixed adenoma and gangliocytoma. One patient has remained headache free for 4 years after surgery. One was pain free for a year, and then headaches returned with tumor recurrence. Another had major improvement, and two have not improved. Patients were generally refractory to medications.
All five of our patients with typical SUNCT had pituitary tumors, with headache ipsilateral to the pituitary tumors in all cases. Tumor removal provided major improvement in three out of five patients. Medical treatment was only partially effective.
短暂单侧丛集性头痛发作伴结膜充血和流泪（SUNCT）和短暂单侧丛集性头痛发作伴颅自主神经症状（SUNA）是三叉神经自主神经性头痛（TAC）的罕见类型。目的：描述一系列具有 SUNCT 和 SUNA 的患者，包括与垂体瘤的关系。
回顾了在卡尔加里头痛评估和管理计划中诊断为 SUNCT 或 SUNA 的所有患者。
确定了 6 名患者（5 名 SUNCT 和 1 名 SUNA）。疼痛剧烈、尖锐，表现为固定的偏侧性，主要累及眶额颞区，并伴有自主神经症状。发作持续时间从 3 秒到 300 秒不等，频率为 1-200 次/天。MRI 显示 5 名 SUNCT 患者中均有同侧垂体腺瘤。有腺瘤的患者接受了手术。病理包括 3 例泌乳素瘤和 1 例混合腺瘤和神经节细胞瘤。一名患者手术后 4 年无头痛。一名患者在 1 年内无疼痛，然后头痛复发。另一名患者有明显改善，两名患者无改善。患者对药物普遍有耐药性。
我们所有 5 名具有典型 SUNCT 的患者均有垂体瘤，所有病例的头痛均位于垂体瘤同侧。肿瘤切除使 5 例患者中的 3 例有明显改善。药物治疗仅部分有效。
