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Headache and Pregnancy. A Multidisciplinary Approach

Sestre Milosrdnice University hospital and Institute of Clinical Medical Research; [email protected]
Publication Date
  • Pregnancy Complications - Etiology
  • Pregnancy Complications - Diagnosis
  • Head And Neck Neoplasms - Diagnosis
  • Pituitary Neoplasms - Diagnosis
  • Komplikacije Trudnoće - Etiologija
  • Komplikacije Trudnoće - Dijagnostika
  • Neoplazme Glave I Vrata - Dijagnostika
  • Neoplazme Hipofize
  • Biology
  • Chemistry
  • Medicine


A 34-year-old pregnant woman presented for neurologic examination for headache and vision impairment. Neurologically, decreased responsiveness of the right pupil and discrete hemiparesis with positive Babinski reflex were objectively observed. During clinical monitoring, periods of neurologic deficit improvement and exacerbation with alternating lateralization were recorded. The appropriate diagnostic (neuroradiologic) work-up could not be employed because of pregnancy and the patient.s refusal to undergo these examinations; therefore, the patient was monitored clinically and by use of methods posing no fetal risk. Upon delivery that proceeded uneventfully, the patient underwent neuroradiologic examinations that revealed an expansive neoplasm in the pituitary region. The patient was operatively treated by transsphenoidal selective adenomectomy. Preoperative hormone test findings as well as histology and immunohistochemistry findings confirmed it to be macroprolactinoma of the pituitary gland. The diagnosis and treatment of this patient required team work of a number of different specialties.

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