Presentation and Management of Headache in Pituitary Apoplexy

  • Himanshu Suri
  • Carrie DoughertyEmail author
Uncommon and/or Unusual Headaches and Syndromes (J Ailani, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Uncommon and/or Unusual Headaches and Syndromes


Purpose of Review

Pituitary apoplexy (PA) occurs in the setting of an infarction and/or hemorrhage of a pre-existing adenoma. The most common presenting symptom is a severe, sudden onset headache. However, the characteristics of headache in the setting of PA are varied and can sometimes mimic primary headache disorders. The purpose of this article is to review the various presentations of headache in PA. We also outline treatment options for persistent headaches following PA.

Recent Findings

A recent retrospective review of patients undergoing transsphenoidal resection of sellar lesions, including PA, found that gross total resection and short duration of preoperative headache were predictors of improvement in headaches postoperatively. This strengthens the importance of timely recognition of PA as potential etiology of headache.


The most common presentation of PA is thunderclap headache; however, several other primary HA disorders have been described including status migraine, SUNCT, and paroxysmal hemicrania


Pituitary apoplexy Headache Thunderclap headache Pituitary adenoma 


Compliance with Ethical Standards

Conflict of Interest

Himanshu Suri and Carrie Dougherty declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of NeurologyGeorgetown University Medical CenterWashington, DCUSA
  2. 2.Department of NeurologyMedStar Georgetown University HospitalWashington, DCUSA

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