Is There an Association Between Pituitary Adenomas and Autonomic Cephalgia?

Abstract

Objective: Trigeminal autonomic cephalalgias (TACs) are a group of primary headache syndromes. Although hemicrania continua (HC)is not included among the TACs according to the International Classification of Headache Disorders (ICHD-II), it also shows autonomic symptoms. In the literature, some authors suggest that TACs can be related with pituitary lesions. In this study, we have compared the pituitary lesions observed in the TAC, HC and migraine-type headache patientsMethods The cranial magnetic resonance images (MRI) of the patients with TAC, HC and migraine without aura (MWOA) unaccompanied by autonomic symptoms were retrospectively evaluated. The 33 TAC and HC patients were compared with the 30 migraine without aura (MWOA) patients. Results: The mean age of the TAC and HC patients was 43. 36±10. 72 years, whereas the mean age of the MWOA patients was 39.0±6.92 years. No statistically significant difference in terms of age was observed between the groups (p˃0.05). The MRI of the TACs and HC patients indicated that 62.5% (n:20) were normal, while 12.5% (n:4) had pituitary microadenomas, 6.3 % (n:2) had macroadenomas, 12.5% (n:4) had suspected pituitary microadenomas, and 6. 3% (n:2) had suspected heterogeneity. The MRI results of the MWOA patients were normal in 46.7% (n:14), whereas 23.3% (n:7) had pituitary microadenomas, 23.3% (n:7) had suspected pituitary microadenomas, and 6. 2% (n:2) had suspected pituitary heterogeneity. No statistically significant difference was observed between both groups (p>0. 05).Conclusion: In this study, no correlation was observed between the TACs, HC and pituitary abnormalities. In conclusion, the use of pituitary MRI has not been supported as a routine method in patients with this type of headache