Headache characteristics in acromegaly: Only a secondary disorder?

IF 5.4 2区 医学 Q1 CLINICAL NEUROLOGY Headache Pub Date : 2025-03-13 DOI:10.1111/head.14927
Giada Giuliani, Denise Costa, Chiara Pellicano, Patrizia Gargiulo, Camilla Virili, Vittorio Di Piero, Marta Altieri
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Abstract

Objective: To investigate the characteristics and nature of headache in a population of patients with acromegaly.

Background: Headache is frequently described by patients with pituitary adenomas. Although it is mainly considered a secondary disorder, it can persist despite effective therapy for pituitary disease. A proper description of headache according to the subtype of pituitary adenoma is not available in literature. In this light, we aimed to analyze headache characteristics in a population of patients with acromegaly.

Methods: In this registry-based retrospective cohort study, headache features were collected through a structured telephone interview. The clinical picture of each patient was classified according to the third edition of the International Classification of Headache Disorders criteria. We carefully investigated the time course and the relationship of headache with acromegaly.

Results: Out of 39 enrolled patients, 27 (69%) reported headache. Six patients (15%) fulfilled secondary headache criteria, with complete headache resolution after acromegaly treatment. In all, 21 patients (54%) met the criteria for a primary headache: fourteen had episodic migraine, four had chronic migraine, and three had tension-type headache. No trigeminal autonomic cephalalgias were observed. The presence of primary headache significantly reduced the time to diagnosis of acromegaly (mean [standard deviation] 2.1 [2.5] vs. 4.3 [3.5] years, p = 0.007). The occurrence of primary headache was similar in patients with macroadenoma compared to patients with microadenoma (14 [67%] vs. 7 [33%], χ2 = 0.591, p = 0.400), while its course was not significantly influenced either by the acromegaly treatment (p = 0.670) or the achievement of biochemical control (p = 0.490).

Conclusion: Secondary headache was found only in a small percentage of our patients. Most of them had a primary headache with a high prevalence of migraine, suggesting that acromegaly might act as a trigger for this disorder. Considering the potentially disabling nature, primary headaches in patients with acromegaly require careful evaluation and personalized management.

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来源期刊
Headache
Headache 医学-临床神经学
CiteScore
9.40
自引率
10.00%
发文量
172
审稿时长
3-8 weeks
期刊介绍: Headache publishes original articles on all aspects of head and face pain including communications on clinical and basic research, diagnosis and management, epidemiology, genetics, and pathophysiology of primary and secondary headaches, cranial neuralgias, and pains referred to the head and face. Monthly issues feature case reports, short communications, review articles, letters to the editor, and news items regarding AHS plus medicolegal and socioeconomic aspects of head pain. This is the official journal of the American Headache Society.
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