Short-lasting, unilateral neuralgiform headache attacks with conjunctival injection and tearing syndrome treated successfully with transsphenoidal resection of a growth hormone-secreting pituitary adenoma

Case report

Restricted access

Short-lasting, unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) syndrome was first described in 1978 as one of the trigeminal autonomic cephalgias. In this paper the authors present a patient with a growth hormone–secreting pituitary adenoma who experienced resolution of SUNCT syndrome after transsphenoidal tumor resection.

Abbreviations used in this paper: GH = growth hormone; SUNCT = short-lasting–unilateral neuralgiform headache attacks with conjunctival injection and tearing; TAC = trigeminal autonomic cephalgia.

Article Information

Address correspondence to: Matthew A. Adamo, M.D., Division of Neurosurgery, Albany Medical Center, Albany, New York 12208. email: adamom@mail.amc.edu.

© AANS, except where prohibited by US copyright law.

Headings

Figures

  • View in gallery

    Coronal (left) and sagittal (right) Gd-enhanced MR images showing microadenoma of the left anterior pituitary gland.

  • View in gallery

    Postoperative coronal (left) and sagittal (right) Gd-enhanced MR images demonstrating resection of the pituitary tumor. Note the fat graft present in the sphenoid sinus.

References

  • 1

    Boes CJSeanson JW: Paroxysmal hemicrania, SUNCT, and hemicrania continua. Semin Neurol 26:2602702006

  • 2

    D'Andrea GGranella FGhiotto NNappi G: Lamotrigine in the treatment of SUNCT syndrome. Neurology 57:172317252001

  • 3

    Gardella LViruega ARojas HNagel J: A case of a patient with SUNCT syndrome treated with the Jannetta procedure. Cephalalgia 21:9969992001

    • Search Google Scholar
    • Export Citation
  • 4

    Graff-Radford SB: SUNCT syndrome responsive to gabapentin (Neurontin). Cephalalgia 20:5155172000

  • 5

    Greve EMai J: Cluster headache-like headaches: a symptomatic feature?. A report of three patients with intracranial pathologic findings. Cephalalgia 8:79821988

    • Search Google Scholar
    • Export Citation
  • 6

    Hannerz JLinderoth B: Neurosurgical treatment of short-lasting, unilateral, neuralgiform hemicrania with conjunctival injection and tearing. Br J Neurosurg 16:55582002

    • Search Google Scholar
    • Export Citation
  • 7

    Hardebo JE: How cluster headache is explained as an intracavernous inflammatory process lesioning sympathetic fibres. Headache 34:1251311994

    • Search Google Scholar
    • Export Citation
  • 8

    Kaphan EEusebio ADonnet AWitjas TAli Cherif A: Short lasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing (SUNCT syndrome) and tumour of the cavernous sinus. Cephalalgia 23:3953972003

    • Search Google Scholar
    • Export Citation
  • 9

    Leone MFranzini AD'Andrea GBroggi GCasucci GBussone G: Deep brain stimulation to relieve drug-resistant SUNCT. Ann Neurol 57:9249272005

    • Search Google Scholar
    • Export Citation
  • 10

    Levy MJJager HRMatharu MSGoadsby PJ: Pituitary tumours and headache: does size matter?. Cephalalgia 22:5922002. (Abstract)

  • 11

    Levy MJMatharu MSMeeran KPowell MGoadsby PJ: The clinical characteristics of headache in patients with pituitary tumours. Brain 128:192119302005

    • Search Google Scholar
    • Export Citation
  • 12

    Massiou HLaunay JMLevy CEl Amrani MEmperauger BBousser MG: SUNCT syndrome in two patients with prolactinomas and bromocriptine-induced attacks. Neurology 58:169816992002

    • Search Google Scholar
    • Export Citation
  • 13

    Matharu MSBoes CJGoadsby PJ: SUNCT syndrome: prolonged attacks, refractoriness and response to topiramate. Neurology 58:13072002

  • 14

    Matharu MSCohen ASBoes CJGoadsby PJ: Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing syndrome: A review. Curr Pain Headache Rep 7:3083182003

    • Search Google Scholar
    • Export Citation
  • 15

    May ABahra ABuchel CFrackowiak RSJGoadsby PJ: Hypothalamic activation in cluster headache attacks. Lancet 352:2752781998

  • 16

    Milos PHavelius UHindfelt B: Clusterlike headache in a patient with a pituitary adenoma. With a review of the literature. Headache 36:1841881996

    • Search Google Scholar
    • Export Citation
  • 17

    Morales-Asin FEspada FLopez-Obarrio LANavas IEscalza IIniguez C: A SUNCT case with response to surgical treatment. Cephalalgia 20:67682000

    • Search Google Scholar
    • Export Citation
  • 18

    Moskowitz MA: Cluster headache—evidence for a pathophysiologic focus in the superior pericarotid cavernous sinus plexus. Headache 28:5845861988

    • Search Google Scholar
    • Export Citation
  • 19

    Pareja JAShen JMKruszewski PCabellero VPamo MSjaastad O: SUNCT syndrome: duration, frequency, and temporal distribution of attacks. Headache 36:1611651996

    • Search Google Scholar
    • Export Citation
  • 20

    Pareja JASjaastad O: SUNCT syndrome: A clinical review. Headache 37:1952021997

  • 21

    Porta-Etessam JRamos-Carrasco ABerbel-Garcia AMartinez-Salio ABenito-Leon J: Clusterlike headache as first manifestation of a prolactinoma. Headache 41:7237252001

    • Search Google Scholar
    • Export Citation
  • 22

    Sjaastad OSaunte CSalvesen RFredriksen TASeim ARoe OD: Shortlasting unilateral neuralgiform headache attacks with conjunctival injection, tearing, sweating, and rhinorrhea. Cephalagia 9:1471561989

    • Search Google Scholar
    • Export Citation
  • 23

    Sprenger TBoecker HTolle TRBussone GMay ALeone M: Specific hypothalamic activation during a spontaneous cluster headache attack. Neurology 62:5165172004

    • Search Google Scholar
    • Export Citation
  • 24

    Sprenger TValet MPlatzer SPfaffenrath VSteude UTolle TR: SUNCT: bilateral hypothalamic activation during headache attacks and resolving of symptoms after trigeminal decompression. Pain 113:4224262005

    • Search Google Scholar
    • Export Citation
  • 25

    Tfelt-Hansen PPaulson OBKrabbe AE: Invasive adenoma of the pituitary gland and chronic migrainous neuralgia. A rare coincidence or a causal relationship?. Cephalalgia 2:25281982

    • Search Google Scholar
    • Export Citation

Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 100 100 14
Full Text Views 93 93 0
PDF Downloads 38 38 0
EPUB Downloads 0 0 0

PubMed

Google Scholar