About this Journal Submit a Manuscript Table of Contents
Case Reports in Neurological Medicine
Volume 2012 (2012), Article ID 830469, 3 pages
http://dx.doi.org/10.1155/2012/830469
Case Report

Cluster Headache Secondary to Macroprolactinoma with Ipsilateral Cavernous Sinus Invasion

1Department of Endocrinology, Leicester Royal Infirmary, Leicester LE1 5WW, UK
2Department of Neurosurgery, Queens Medical Centre, Nottingham NG7 2UH, UK

Received 23 May 2012; Accepted 13 August 2012

Academic Editors: S. D. Chang and J. C. Kattah

Copyright © 2012 M. J. Levy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We present a 25 year-old man with episodic cluster headache that was refractory to all standard pharmacological prophylactic and abortive treatments. Because of the lack of response, an MRI brain was performed which showed a large pituitary tumour with ipsilateral cavernous sinus invasion. The serum prolactin was significantly elevated at 54,700 miU/L (50–400) confirming a macro-prolactinoma. Within a few days of cabergoline therapy the headache resolved. He continues to be headache free several years after starting the dopamine agonist. This case highlights the importance of imaging the pituitary fossa in patients with refractory cluster headache, It also raises the potential anatomical importance of the cavernous sinus in pituitary-associated headache.