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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Intractable SUNCT cured after resection of a pituitary microadenoma.
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Intractable SUNCT cured after resection of a pituitary microadenoma.

机译：垂体微腺瘤切除术后顽固性SUNCT治愈。

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BACKGROUND: SUNCT is a rare primary headache disorder that is associated with activation of the posterior hypothalamus and often poorly responsive to medication. Recently, a relationship between between pituitary microadenoma and SUNCT has been suggested, and reports of both amelioration and exacerbation by dopamine-agonists have been published. These findings suggest a functional role for the hypothalamic-pituitary axis in SUNCT. METHODS: We report the long-term 4 year follow-up of a 35 year-old patient with a 14-year history of medically and surgically intractable SUNCT who experienced immediate and complete resolution of symptoms after resection of a 6 mm pituitary microadenoma. RESULTS: This patient was first seen at the age of 28 years with a 10-year history of attacks of right retro-orbital pain satisfying the IHS criteria for SUNCT. Many medical and surgical treatments were attempted without success. An MRI demonstrated a 6 mm microadenoma without compression of surrounding structures. A trial of bromocriptine caused marked exacerbation of his pain. The patient underwent a trans-sphenoidal resection of the pituitary lesion. SUNCT attacks worsened for the first 24h post-operatively, then disappeared. He has been completely headache-free, without medication, for the past 43 months with the last follow-up being January 2006. CONCLUSION: This case emphasizes the relationship between pituitary microadenomas and SUNCT, supports the role of the hypothalamic-pituitary axis in the genesis of SUNCT, and illustrates the importance of careful imaging of the pituitary region in patients with SUNCT.
机译：背景：SUNCT是一种罕见的原发性头痛疾病，与下丘脑后部的激活有关，通常对药物的反应较差。最近，已经提出垂体微腺瘤和SUNCT之间的关系，并且已经发表了多巴胺激动剂改善和加重的报道。这些发现提示在SUNCT中下丘脑-垂体轴的功能作用。方法：我们报告了一名35岁的患者的长期4年随访，该患者具有14年的内科和外科手术难治性SUNCT病史，这些患者在切除6毫米垂体微腺瘤后立即获得了症状的完全缓解。结果：该患者首次出现在28岁，患有10年的右后眶疼痛发作病史，符合SUNCT的IHS标准。尝试了许多医学和外科治疗均未成功。 MRI显示6毫米的微小腺瘤，周围结构未受压。溴隐亭的试验使他的疼痛明显加重。该患者进行了垂体病变的经蝶骨切除。 SUNCT术后24h发作恶化，然后消失。在过去的43个月中，他完全没有头痛，没有药物治疗，最后一次随访是2006年1月。结论：该病例强调了垂体微腺瘤与SUNCT之间的关系，支持了下丘脑-垂体轴在脑内的作用。 SUNCT的起源，并阐明了SUNCT患者垂体区域仔细成像的重要性。

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