{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:51:42Z","timestamp":1787014302154,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T00:00:00Z","timestamp":1741824000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the characteristics and nature of headache in a population of patients with acromegaly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this registry\u2010based 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\n                      <jats:italic>International Classification of Headache Disorders<\/jats:italic>\n                      criteria. We carefully investigated the time course and the relationship of headache with acromegaly.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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\u2010type 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\u2009[2.5] vs. 4.3\u2009[3.5]\u2009years,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007). The occurrence of primary headache was similar in patients with macroadenoma compared to patients with microadenoma (14 [67%] vs. 7 [33%], \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.591,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.400), while its course was not significantly influenced either by the acromegaly treatment (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.670) or the achievement of biochemical control (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.490).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.14927","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T09:44:31Z","timestamp":1741859071000},"page":"826-834","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Headache characteristics in acromegaly: Only a secondary disorder?"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5910-6043","authenticated-orcid":false,"given":"Giada","family":"Giuliani","sequence":"first","affiliation":[{"name":"Department of Human Neuroscience Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, Endocrinology\u2010Pituitary Disease Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Pellicano","sequence":"additional","affiliation":[{"name":"Department of Translational and Precision Medicine Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Gargiulo","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, Endocrinology\u2010Pituitary Disease Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Virili","sequence":"additional","affiliation":[{"name":"Department of Medico\u2010Surgical Sciences and Biotechnologies Sapienza University of Rome  Latina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Di Piero","sequence":"additional","affiliation":[{"name":"Department of Human Neuroscience Sapienza University of Rome  Rome Italy"},{"name":"University Consortium for Adaptive Disorders and Head Pain (UCADH)  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Altieri","sequence":"additional","affiliation":[{"name":"Department of Human Neuroscience Sapienza University of Rome  Rome 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