Pituitary adenoma and headache

Abstract

Background: Although headache and pituitary adenoma are two prevalent conditions that may coexist, it has also been postulated that pituitary adenomas may cause secondary headaches that resemble primary headaches. Headache alone is so far a controversial indication for treatment of pituitary adenoma. Purpose: To gain knowledge about the relationship between pituitary tumours and headache, and possible symptomatic effects of treatment. Materials and method: Patients diagnosed with or treated for pituitary adenomas in a 10-year period in a single institution were invited to participate in the study. The 208 (86%) included patients underwent structured telephone interviews concerning current and prior headache complaints while type of tumour, endocrine variables, treatment variables, MRI variables and headache history were recorded from medical records. Headache prevalence among patients was compared to identical measures of headache prevalence from a regional population based study in volunteers. Results: The current cross sectional age and sex-adjusted 1-year prevalence of headache suffering (21%) is significantly lower than the general population (37%) p<0.001. Assessed retrospectively, prevalence of headaches was significantly higher (48%) p<0.001 before being diagnosed with pituitary adenomas than in the general population. With the exception of family history of headache (p=0.020), no associations between headache and measured clinical or radiological variables were identified. Conclusion: Although patients retrospectively reported relief of headache complaints after treatment current prevalence of headaches among patients harbouring both treated and untreated pituitary adenomas is low compared to the general population. Furthermore, the lack of variables associated with headache suggests that headache alone as a sole indication for treatment of pituitary tumours is still debatable