title: Clinical characteristics and risk factors for headache associated with non-functioning pituitary adenomas.
abstract: Background Headaches associated with pituitary adenoma have been reported to be related to the structural characteristics and endocrine factors of the tumour itself. Objectives The objective of this study was to investigate the prevalence and clinical characteristics of, and the risk factors for, non-functioning pituitary adenoma (NFPA)-associated headaches in Chinese patients with normal endocrine activity. Methods Ninety-seven patients with a NFPA with normal endocrine laboratory results were prospectively enrolled in this study. The relevant clinical demographic data were collected and examined with the appropriate statistical methods. Results The pre-operative prevalence of tumour-associated headaches was 48.5%; 87.2% of these patients had migraine-like headaches. A family history of primary headache (odds ratio (OR) 3.67; p = 0.032) and a higher tumour Knosp grade (OR 1.83; p = 0.001) were identified as risk factors for the occurrence of NFPA-associated headaches. The patient's age, sex, visual disturbances, optic chiasm compression, tumour size and tumour volume were not significantly associated with NFPA-associated headaches ( p > 0.05). In addition, headache severity was significantly correlated with the Knosp grade ( r = 0.339; p = 0.001). The sides of the headaches and of cavernous sinus invasion were significantly concordant (48.9% agreement; κ = 0.257; p = 0.007). Conclusions Migraine-like headaches are a common clinical manifestation in patients with NFPAs. A family history of primary headaches and cavernous sinus invasion are risk factors for NFPA-associated headaches.
authors.affiliation: 1 Department of Anesthesiology and Pain Management, Beijing Tiantan Hospital, Capital Medical University, P.R. China.
authors.forename: Bin
authors.initials: B
authors.lastname: Yu
authors.affiliation: 2 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, P.R. China.
authors.forename: Nan
authors.initials: N
authors.lastname: Ji
authors.affiliation: 3 Department of Anesthesiology, Beijing Bo'ai Hospital, P.R. China Rehabilitation Research Center, Capital Medical University School of Rehabilitation Medicine, P.R. China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Ma
authors.affiliation: 2 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, P.R. China.
authors.forename: Bao
authors.initials: B
authors.lastname: Yang
authors.affiliation: 2 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, P.R. China.
authors.forename: Peng
authors.initials: P
authors.lastname: Kang
authors.affiliation: 1 Department of Anesthesiology and Pain Management, Beijing Tiantan Hospital, Capital Medical University, P.R. China.
authors.forename: Fang
authors.initials: F
authors.lastname: Luo
mesh_terms: D000236:Adenoma / Q000150:complications* / Q000473:pathology*; D002426:Cavernous Sinus / Q000473:pathology; D005260:Female; D006261:Headache / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications* / Q000473:pathology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors
keywords: Pituitary adenoma; headache; migraine headache; non-functioning pituitary adenoma; prevalence