Perimenopause Pituitary Hyperplasia with Headache

Clinical Image

Austin J Obstet Gynecol. 2024; 11(1): 1225.

Perimenopause Pituitary Hyperplasia with Headache

Md Ejaz Alam; Pooran Sharma; Shazia Wani; Shahnawaz Mir*

Department of Endocrinology, Government Medical College, Srinagar, India

*Corresponding author: Shahnawaz Ahmad Mir Assistant Professor, Department of Endocrinology, Government Medical College associated SSH, Srinagar, Jammu and Kashmir, India. Email: ejazpmch@gmail.com

Received: November 27, 2023 Accepted: January 01, 2024 Published: January 08, 2024

Clinical Image

Keywords: Pituitary hyperplasia; Headache; Perimenopause

A 50 year-old female presented to the outpatient clinic with one year- history of headache, which was dull frontal mild to moderate in intensity didt not cause any impairment of routine activities. Patient complains of sever menaupsal symptoms. She denied any visual changes, nausea, vomiting, or other neurological symptoms. The patient had no significant past medical or surgical history and was not taking any medications. On examination, the patient was alert and oriented with normal vital signs. Cranial nerve examination was unremarkable, and there were no focal neurological deficits. The rest of the physical examination was within normal limits. Magnetic Resonance Imaging (MRI) of the brain revealed pituitary hyperplasia, with a size of 1.5 cm in the largest dimension (Figure 1). The optic chiasm was normal, and there was no evidence of a mass effect (Figure 2).

Figure 1: 


    


    

    


    


    Figure 1:

Figure 2: 


    


    

    


    


    Figure 2:

Further evaluation of pituitary function revealed normal levels of prolactin, growth hormone, adrenocorticotropic hormone, thyroid-stimulating hormone, follicle stimulating hormone and luteinizing hormone were in menopause range.The patient’s cortisol level was also within normal limits. The patient was managed conservatively with close follow-up.

References

  1. Corpus H. Cite this as BMJ. BMJ. 2011; 342.
  2. Dunn PM. Soranus of Ephesus (circa AD 98-138) and perinatal care in Roman times. Arch Dis Child Fetal Neonatal Ed. 1995; 73: F51-2.
  3. Griet Vandenberghe, Anne Vierin, Kitty Bloemenkamp, Sylvia Berlage, Lotte Colmorn, Catherine Deneux- Tharaux, et al. Incidence and outcomes of uterine rupture in women with unscarred, preterm or pre-labour uteri: data from the international network of obstetric survey systems. 2023; 130: 1493-1501.
  4. Sugai Shunya, Yamawaki Kaoru, Haino Kazufumi, Yoshihara Kosuke, Nishijima Koji. Incidence of Recurrent Uterine Rupture A Systematic Review and Meta-analysis. Obstetrics & Gynecology. 2023; 142: 1365-1372.
  5. Panel Kaouther Dimassi, Olivier AMI, Rania Merai, Luka Velemir, Benedicte Simon, et al. Double-layered purse string uterine suture compared with single-layer continuous uterine suture: A randomised controlled trial. J Gynecol Obstet Hum Reprod. 2022; 51: 102282.
  6. Richards EG, Rehmer JM, Falcone T. Impact of selected risk factors on uterine healing after cesarean section in women with single-layer uterine closure: A prospective study using two- and three-dimensional transvaginal ultrasonography. Adv Clin Exp Med. 2022; 31: 41-48.
  7. Richards EG, Rehmer JM, Falcone T. Perforation During Gynecological Procedures. JAMA. 2023; 329: 933-934.
  8. Zhou Q, Zhou X, Feng L, Wang SS. Complete Rupture of the Pregnant Uterus: A 10-year Retrospective Descriptive Study. Curr Med Sci. 2022; 42: 177-184.
  9. Surekha Tayade, Arzoo Chadha, Smriti Khandelwal, Nidhi Makhija, Hard Tilva, Sparsh Madaan. Uterine Rupture Following Non-Operative Vaginal Delivery: A Close Save of Delayed Presentation With Hemoperitoneum to a Rural Tertiary Care Hospital. Cureus. 2022; 14: e21076.
  10. Dimitrova D, Kastner AL, Kastner AN, Paping A, Henrich W, et al. Risk factors and outcomes associated with type of uterine rupture. Arch Gynecol Obstet. 2022; 306: 1967-1977.
  11. Hochler H, Wainstock T, Lipschuetz M, Sheiner E, Ezra Y, Yagel S, et al. Grandmultiparity, maternal age, and the risk for uterine rupture-A multicenter cohort study. Acta Obstet Gynecol Scand. 2020; 99: 267-273.
  12. Vimercati A, Dellino M, Suma C, Damiani GR, Malvasi A., Cazzato G. et al. Spontaneous uterine rupture and adenomyosis, a rare but possible correlation: case report and literature review. Diagnostics (Basel). 2022; 12: 1574.
  13. Kishi Y, Suginami H, Kuramori R, Yabuta M, Suginami R, Taniguchi F. Four subtypes of adenomyosis assessed by magnetic resonance imaging and their specification. Am J Obstet Gynecol. 2012; 207: 114.e1-7.
  14. Sharon N, Maymon R, Pekar-Zlotin M, Betser M, Melcer Y. Midgestational pre-labor spontaneous uterine rupture: a systematic review. J Matern Fetal Neonatal Med. 2022; 35: 5155-5160.
  15. Kishi Y, Suginami H, Kuramori R, Yabuta M, Suginami R, Taniguchi F, et al. Four subtypes of adenomyosis assessed by magnetic resonance imaging and their specification. Am J Obstet Gynecol. 2012; 207: 114.e1-7.
  16. Azziz R. Adenomyosis in pregnancy. A review. J Reprod Med. 1986; 31: 224-7.
  17. Miller DA, Goodwin TM, Gherman RB, Paul RH. Intrapartum rupture of the unscarred uterus. Obstet Gynecol. 1997; 89: 671-3.
  18. Joseph J Noh, Cheol-Ho Park, Mi-Hyun Jo, Ja-Young Kwon. Rupture of an unscarred uterus in a woman with long-term steroid treatment for systemic lupus erythematosus. Obstet Gynecol. 2013; 122: 472-475.
  19. Kim HS, Oh SY, Choi SJ, Park HS, Cho GJ, Chung JH, et al. Uterine rupture in pregnancies following myomectomy: A multicenter case series. Obstet Gynecol Sci. 2016; 59: 454-62.
  20. Zhou Q, Zhou X, Feng L, Wang SS. Complete rupture of the Pregnant uterus: A 10-year Retrospective Descriptive Study. Curr Med Sci. 2022; 42: 177-84.
  21. Andrea Tinelli, Ioannis P Kosmas, Jose “Tony” Carugno, Howard Carp, Antonio Malvasi, Shlomo B Cohen, et al. Uterine rupture during pregnancy: The URIDA (uterine rupture international data acquisition) study. Gynecology & Obstetrics. 2022; 157: 76-84.
  22. Saleem HA, Edweidar Y, Salim MA, Mahfouz IA. Mid-trimester spontaneous rupture of a bicornuate uterus: A case report. Case Reports in Women’s Health. 2023; 39: e00524.
  23. Al-Zirqi I, Vangen S. Pregnancies in Women with a Previous Complete Uterine Rupture. Obstet Gynecol Int. 2023; 2023: 9056489.
  24. Sharon N, Maymon R, Pekar-Zlotin M, Betser M, Pages YM. Midgestational pre-labour spontaneous uterine rupture: a systematic review. J Matern Fetal Neonatal Med. 2022; 35: 5155-60.

Citation: Ejaz Alam MD, Sharma P, Wani S, Mir S. Perimenopause Pituitary Hyperplasia with Headache. Austin J Obstet Gynecol. 2024; 11(1): 1225.