title: SUNCT, SUNA and pituitary tumors: clinical characteristics and treatment.
abstract: BACKGROUND
  Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) are rare types of trigeminal autonomic cephalalgias (TACs). Objective To describe a series of patients with SUNCT and SUNA including relationship to pituitary tumors.
  
  
  METHODS
  All patients diagnosed with SUNCT or SUNA in the Calgary Headache Assessment and Management Program were reviewed.
  
  
  RESULTS
  Six patients (five SUNCTs and one SUNA) were identified. The pain was severe, sharp, showed fixed-laterality, involved mainly the orbito-fronto-temporal region and was associated with autonomic symptoms. Attack duration ranged from 3 to 300 seconds and frequency was 1-200 paroxysms/day. MRI showed ipsilateral pituitary adenomas to the pain in five out of five of the SUNCT patients. Patients with adenomas underwent surgery. Pathology included three prolactinomas, and one mixed adenoma and gangliocytoma. One patient has remained headache free for 4 years after surgery. One was pain free for a year, and then headaches returned with tumor recurrence. Another had major improvement, and two have not improved. Patients were generally refractory to medications.
  
  
  CONCLUSIONS
  All five of our patients with typical SUNCT had pituitary tumors, with headache ipsilateral to the pituitary tumors in all cases. Tumor removal provided major improvement in three out of five patients. Medical treatment was only partially effective.
authors.affiliation: Department of Clinical Neurosciences, University of Calgary and Alberta Health Services, Canada.
authors.forename: Prin
authors.initials: P
authors.lastname: Chitsantikul
authors.forename: Werner J
authors.initials: WJ
authors.lastname: Becker
mesh_terms: D000236:Adenoma / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D050798:SUNCT Syndrome / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*