Department of Neurology, Georgetown University Medical Center, Washington, DC, USA.
Department of Neurology, MedStar Georgetown University Hospital, 3800 Reservoir Road NW, Washington, DC, 20007, USA.
Curr Pain Headache Rep. 2019 Jul 29;23(9):61. doi: 10.1007/s11916-019-0798-5.
Pituitary apoplexy (PA) occurs in the setting of an infarction and/or hemorrhage of a pre-existing adenoma. The most common presenting symptom is a severe, sudden onset headache. However, the characteristics of headache in the setting of PA are varied and can sometimes mimic primary headache disorders. The purpose of this article is to review the various presentations of headache in PA. We also outline treatment options for persistent headaches following PA.
A recent retrospective review of patients undergoing transsphenoidal resection of sellar lesions, including PA, found that gross total resection and short duration of preoperative headache were predictors of improvement in headaches postoperatively. This strengthens the importance of timely recognition of PA as potential etiology of headache. The most common presentation of PA is thunderclap headache; however, several other primary HA disorders have been described including status migraine, SUNCT, and paroxysmal hemicrania.
垂体卒中（PA）发生于既往存在的腺瘤发生梗死和/或出血的情况下。最常见的首发症状是严重的、突发的头痛。然而，PA 患者头痛的特征是多种多样的，有时可能类似于原发性头痛障碍。本文的目的是综述 PA 患者头痛的各种表现。我们还概述了 PA 后持续性头痛的治疗选择。
最近一项对接受经蝶窦鞍区病变切除术（包括 PA）的患者进行的回顾性研究发现，大体全切除和术前头痛持续时间短是术后头痛改善的预测因素。这进一步证实了及时识别 PA 作为头痛潜在病因的重要性。PA 最常见的表现是霹雳样头痛；然而，也有其他几种原发性头痛障碍被描述，包括丛集性头痛、SUNCT 和阵发性半边头痛。
