Neurológia pre prax 1/2012

Endocrinally influenced headaches

Migraine is a typical disease with a significant influence of women sex hormones. In trigeminal autonomic cephalgias is activated hypothalamus during attacks. Migrainelike headache is the most common presentation of pituitary adenomas, clusterlike headache is less often. Pituitary apoplexy is manifested by thunderclap headache. Headache is presented in 30 % patient with hypothyroidism. Paroxysmal headache occur in 50–80 % patients with phaeochromocytoma. Migraines with aura in females is more likely to worsen due to combined oral hormonal contraception and are higher at risk of migraine stroke, especially with those who smoke. Administration of hormone replacement therapy leaves the frequency of preexisting migraine in more than half women unchanged. Estrogen replacement can be provocative for migraines with aura or isolated aura.

Keywords: headache, pituitary adenoma, thyroid, hormonal contraception, hormone replacement therapy.