Does your very bad headache have you thinking you have a brain tumor? Though the only way to rule out a tumor is with a scan of your brain, this doesn’t mean that a really bad headache is most likely cancer.
In fact, one cause of an really bad headache is a leak of spinal cord fluid, says a study reported in Neurology (Dec. 25, 2000). In the study, eleven patients with headaches were found to have enlarged pituitary glands (the gland is in the brain). Their headache symptoms were those of intracranial hypotension syndrome.
Hypotension means low blood pressure. This intracranial syndrome causes headaches when the person sits up from a lying position; or, an ongoing headache while lying will become worse when the patient sits up from the lying position.
“The incapacitating headaches experienced by sufferers of this disorder can now be explained and treated, and not confused for a brain tumor,” explains Jerome Posner, MD, Memorial Sloan-Kettering Cancer Center neurologist and co-author of an editorial accompanying this study.
This condition is diagnosed by a reading of low spinal cord fluid pressure. However, intracranial hypotension, at least in the study subjects, had a variety of etiologies, such as unexplained fluid loss, spontaneous occurrence, cervical spine surgery, and lumbar puncture via spinal tap. The headaches were accompanied by nausea, neck pain, visual and hearing problems, and even facial numbness.
So what causes the pituitary gland to become enlarged in this syndrome? The researchers believe that the sinuses, that surround the gland, accommodate the low fluid pressure. They do this by becoming engorged…with blood. This doesn’t make the diagnosis easy.
However, the study results could prevent some people from getting mistakenly diagnosed with brain tumor, when they really have intracranial hypotension syndrome.
So how enlarged were the study participants’ pituitary glands? According to MRI exams, the pituitary glands were 50 percent larger, on average, than normal. Thank goodness for MRI technology, because without it, the syndrome could more easily be misdiagnosed as a brain tumor. And meanwhile, until the right diagnosis is made, these patients would suffer with very bad headaches.
How is intracranial hypotension syndrome treated? Conventional treatments work for many people, and these include hydration, bed rest, caffeine and corticosteroids. In the most severe cases of intracranial hypotension syndrome, surgery is used to repair the leak
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