Growth hormone-induced chronic migraine and intracranial hypertension: A pediatric course of persistent disease and literature review

Editor’s note: The research described below comes from a recipient of a 2025 MSC Travel Grant supporting travel to the 67th Annual Scientific Meeting of the American Headache Society. These grants reimburse travel expenses for those who have had their abstract for a presentation or poster accepted at a meeting.

By Aysha Siddika, MD, headache medicine fellow, University of Miami, US

What is the research gap that your study addresses?

The first case report discusses gaps in research on the growth hormone (GH)-induced prolonged pseudotumor cerebrii and its association with migraine chronification.

The second case report discusses a gap in research on chemoradiation-associated secondary headaches in immunocompromised individuals, and the importance of early recognition and mortality.

What methodology did you use to address your research hypothesis?

Literature review.

What are the main results of your study?

1. Literature review analysis revealed that among 142 GH-associated intracranial hypertension (IH) cases, 117 (82.3%) developed symptoms within 2 years of GH initiation, with 95 (69%) occurring within 6 months and 58 (41%) within 2 months. Most patients (n=100) improved within 2 years, with 95% achieving symptom resolution within 6 months of GH discontinuation.
2. Central nervous system aspergillosis constitutes a grave opportunistic infection in immunocompromised patients, exhibiting mortality rates of 77% to 100% when complicated by stroke. Atypical clinical presentations, including isolated headache and cerebrovascular events, remain underreported in the literature.

What conclusions did you reach based on your results?

1. This case demonstrates that GH-induced IH can persist long-term despite brief exposure, resulting in sustained alterations in CSF dynamics, in susceptible individuals.
2. Early recognition of red flags, prompt diagnosis, and aggressive management are essential to improve outcomes in high-risk immunocompromised patients.

What is the relevance of your study to migraine?

Both case reports discuss different patterns and red flags of chronic secondary headache disorders that can be easily mistaken for migraine and ultimately dismissed by many providers if not evaluated carefully. Also, the first case highlights the importance of managing high-frequency headaches and prevention of chronification and development of refractory migraine. The second case highlights the importance of recognizing red flags in high-risk immunocompromised patients with a history of migraine.