What causes intermittent pain on the right side of the head?

Headache is a very common physical disease in daily life. Headache will not only affect normal life, but also easily lead to some head diseases, which is very harmful to health. Intermittent pain on the right side of the head is also a common symptom. Generally, this may be caused by poor secretory function of the pituitary gland in the human body, and it requires careful observation.

What causes intermittent pain on the right side of the head?

Causes

Non-functioning pituitary adenomas are actually a group of heterogeneous tumors, most of which have the function of division (mostly gonadotropin), but their secretion function is low and does not cause an increase in blood hormone levels. This type of tumor is called a silent adenoma. Some non-functioning adenomas may indeed have no secretory function, and their cell origin is unclear, which is called naked cell tumor or featureless cell adenoma.

Clinical manifestations

Pituitary adenomas without the function of secreting biologically active hormones mainly include two aspects of clinical manifestations: ① The tumor expands outside the sella turcica and compresses the adjacent tissue structures. This type of symptom is the most common and is often the main reason for patients to seek medical treatment; ② Due to the compression and destruction of normal pituitary tissue around the tumor, it causes varying degrees of hypopituitarism. Pituitary tumors with the function of secreting biologically active hormones also have clinical manifestations of hypersecretion of one or more pituitary hormones.

1. Compression symptoms

(1) Headache: It occurs in 1/3 to 2/3 of patients. It is not severe in the early stage and is mainly characterized by bloating and pain, which may worsen intermittently. The headache area is mostly in the temples, forehead, behind the eyeballs or root of the nose. The main cause of headache is that the diaphragm sella and the surrounding dura mater are pulled due to the upward growth of the tumor. When the tumor penetrates the diaphragm sella, the pain may be relieved or disappear.

(2) Compression of the optic nerve pathway: Pituitary adenoma extends above the sella turcica and compresses the optic chiasm, which can cause different types of visual field defects with or without decreased vision. This is due to different directions of tumor growth and variations in the anatomical relationship between the optic chiasm and the pituitary gland.

(3) Other symptoms: When the tumor expands to both sides of the sella turcica and compresses the cavernous sinus, it may cause the so-called cavernous sinus syndrome (damage to the III, IV, V and VI cranial nerves). Double vision may occur if the eye motor nerve located within it is damaged. Some patients may also experience loss of smell due to damage to the olfactory nerve. Giant adenomas may invade the hypothalamus. The tumor compresses the hypothalamus but does not invade it, and there may be no obvious manifestation of hypothalamic dysfunction. If it invades the inside, a series of symptoms such as diabetes insipidus, drowsiness, and temperature regulation disorders may occur. If the tumor compresses the third ventricle and blocks the interventricular foramen, it will cause hydrocephalus and increased intracranial pressure, and aggravate the headache. The tumor may occasionally extend to the frontal lobe and temporal lobe, causing epileptic convulsions, hemiplegia, pyramidal tract signs, and psychiatric symptoms. When the tumor erodes the sella turcica and sphenoid sinus, it may cause cerebrospinal fluid rhinorrhea.

2. Hormone secretion abnormalities

(1) Decreased secretion of pituitary hormones: In patients with pituitary tumors, decreased secretion of pituitary hormones is generally mild and progresses slowly. Only after three-quarters of the gland has been destroyed will obvious clinical symptoms of hypopituitarism appear. Even if the tumor is large, symptoms of hormone deficiency rarely reach the severity seen after hypophysectomy. Therefore, in general, pituitary tumors rarely show symptoms of decreased pituitary hormone secretion, especially functional adenomas. However, sometimes decreased secretion of pituitary hormones can also be a prominent manifestation of this disease, which is particularly obvious in childhood, manifested as short stature and incomplete sexual development. Sometimes the tumor can also affect the hypothalamus and neurohypophysis, and the synthesis and secretion disorders of vasopressin cause diabetes insipidus.