Abstract
The menstrual cycle is controlled by the central nervous system and alterations in its function may be a reflection of neurological disease. Although longstanding increased intracranial pressure (ICP) may produce subtle but important changes such as learning disabilities, there may be few clues to identify increased ICP as the cause. We have recently seen two patients with longstanding learning disabilities in whom amenorrhea provided the impetus for CT scanning. One patient presented at 20 years of age and had an initial prolactin of 42. She had a 3rd ventricle cyst causing obstructive hydrocephalus. The second patient presented at 17 years of age with amenorrhea and severe headaches. Prolactin was 29.5 ng/ml. Hydrocephalus due to a 4th ventricle ependymoma was found on CT. Spontaneous menses occurred in the second patient after placement of a shunt. Her prolactin level gradually fell to normal but menses resumed before the prolactin fall. The first patient initially required medroxyprogesterone acetate postoperatively but resumed spontaneous menses when she was placed on spironolactone for her hirsuitism.
CONCLUSIONS: 1) Amenorrhea may be an important clue to the presence of increased intracranial pressure and intracranial neoplasia, 2) Hypo-thalamic compression rather than hyperprolactinemia appears to be the mechanism of amenorrhea in our cases.
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Redmond, G., Gidwani, G., Bay, J. et al. 170 MENSTRUAL DYSFUNCTION IN ADOLESCENTS WITH INCREASED JNTIMCRANLAL PRESSURE. Pediatr Res 19, 631 (1985). https://doi.org/10.1203/00006450-198506000-00190
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DOI: https://doi.org/10.1203/00006450-198506000-00190