[Migraine-like headache secondary to pituitary macroadenoma].

BACKGROUND

Differential diagnosis of migraine-like headache with and without aura needs to proceed with neuroimaging evaluation in order to rule out any secondary conditions. We report a patient with a 2 year history of migraine like headache with a good response to ergotics and due to pituitary macroadenoma.

METHODS

A 44 year old man with no familiar history of migraine presented to our hospital because of campimetric failure and a change of his migrainous features. The patient started with migraine without aura 2 years ago and was well treated with ergotics from the beginning. Field testing showed a bitemporal hemianopsia. Magnetic resonance imaging revealed an unknown pituitary macroadenoma.

CONCLUSIONS

Pituitary macroadenoma must be included in the differential diagnosis of migraine headache although the presence of aura or the good response to ergotics.