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Dr. Andrew Rynne

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Suggest remedy for severe headache

I have a macroprolactinoma. I have developed severe headaches over the last month with neck pain over the last 4 days. I had an MRI completed last week with no change from last year on tumor size. My endocrinologist told me to contact my neurosurgeon for a consult but he cannot see me for a month. Should I be worried about the headaches? I have known about the tumor for 3 years with no side effects until now. What should I do?
Mon, 12 Oct 2020
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Neurologist, Surgical 's  Response
Hello,

Severe headache in a case of Pituitary macro adenoma could be due to:
- Migraine - Migraine is a severe type of headache, which occurs on one side, associated with eye ache, neck pain, nausea and photophobia. It is typically associated with pituitary tumor.
- Dural stretching by tumor can cause severe headache. Dura is covering of brain, which can be stretched by tumor. It is pain sensitive. It can cause severe headache.
- Bleed or edema in tumor (Pituitary apoplexy) - It is the most dangerous complication. Bleed or swelling (edema) in tumor can cause severe headache, neck pain. It can cause loss of vision, vomiting, uncontrollable headache. To rule out it, contrast MRI brain with pituitary cuts is needed.

Please match your symptoms from above differentials. You should be concerned if there is blurring of vision. Try to consult neurosurgeon or at least get a scan to rule out apoplexy. To get relief in pain, you should:
- Take rest
- Take Naproxen or ibuprofen or a combination of ibuprofen and paracetamol after prescription
- Apply Diclofenac gel over neck. Massage neck and apply hot fomentation.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Ishu Bishnoi, Neurologist, Surgical
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Suggest remedy for severe headache

Hello, Severe headache in a case of Pituitary macro adenoma could be due to: - Migraine - Migraine is a severe type of headache, which occurs on one side, associated with eye ache, neck pain, nausea and photophobia. It is typically associated with pituitary tumor. - Dural stretching by tumor can cause severe headache. Dura is covering of brain, which can be stretched by tumor. It is pain sensitive. It can cause severe headache. - Bleed or edema in tumor (Pituitary apoplexy) - It is the most dangerous complication. Bleed or swelling (edema) in tumor can cause severe headache, neck pain. It can cause loss of vision, vomiting, uncontrollable headache. To rule out it, contrast MRI brain with pituitary cuts is needed. Please match your symptoms from above differentials. You should be concerned if there is blurring of vision. Try to consult neurosurgeon or at least get a scan to rule out apoplexy. To get relief in pain, you should: - Take rest - Take Naproxen or ibuprofen or a combination of ibuprofen and paracetamol after prescription - Apply Diclofenac gel over neck. Massage neck and apply hot fomentation. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Ishu Bishnoi, Neurologist, Surgical