Not a brain tumor: serious headaches explained

December 25, 2000

ST. PAUL, MN - Headaches that may at first seem to be caused by a brain tumor can actually stem from a leak of spinal cord fluid, according to a study in the December 25 issue of Neurology, the scientific journal of the American Academy of Neurology.

Spanish researchers identified enlarged pituitary glands in the brains of 11 patients with headache symptoms characterized as intracranial hypotension syndrome. People suffering from this syndrome experience headaches that occur or worsen shortly after sitting up from a lying position.

"This is a disorder that was recently believed to be rare. New imaging technology has told us quite the opposite," said Jerome Posner, MD, Memorial Sloan-Kettering Cancer Center neurologist and co-author of an editorial accompanying the study. "The incapacitating headaches experienced by sufferers of this disorder can now be explained and treated, and not confused for a brain tumor."

Primarily diagnosed by a low spinal cord fluid pressure reading, the intracranial hypotension experienced by study participants had varied causes including spontaneous occurrence, unexplained fluid loss, lumbar puncture (spinal tap) and cervical spine surgery. Neck pain, nausea, hearing and vision problems and facial numbness accompanied the headaches.

Researchers think that the pituitary gland enlargement in intracranial hypotension syndrome results from the sinuses surrounding the pituitary gland compensating for the low fluid pressure by becoming engorged with blood. The condition can make for a tricky diagnosis.

"In a sense, the knowledge gained from this study could prevent some patients with intracranial hypotension syndrome from being diagnosed with a pituitary adenoma, or brain tumor," said study author Julián Benito-León, MD, of the Hospital General de Móstoles in Madrid, Spain.

MRI exams of the study participants showed pituitary glands an average of 50 percent larger than normal. Before advances in MRI technology, intracranial hypotension might have been inaccurately diagnosed as tumorous growth, delaying the correct course of treatment for suffering patients.

Many patients respond to conventional treatments such as bed rest, hydration, caffeine and corticosteroids. Surgical repair of the leak is performed in only the most severe cases.
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For more information contact: Dan Bensman (651) 695-2789 or dbensman@aan.com

A neurologist is a medical doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system.

The American Academy of Neurology, an association of more than 17,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research.

For more information about the American Academy of Neurology, visit its Web site at www.aan.com. For online neurological health and wellness information, visit NeuroVista at www.aan.com/neurovista.

American Academy of Neurology

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