This longitudinal cohort study presents data with significant clinical implications for patients with headaches and the clinicians and surgeons who treat them. For the study, patients completed a self-administered survey on headache characteristics on initial presentation and after surgery of the pituitary gland. The study found that frequent, disabling headaches were common in patients with pituitary lesions, especially amongst younger women with a pre-existing headache disorder. Seventy-two percent of the patients reported headaches localised to the anterior region of the head. Forty-seven percent of the patients had reported prior diagnosis of migraine or other primary headache. Pituitary surgery was found to improve or resolve headache in the majority of patients with disabling headaches prior to pituitary surgery. According to the authors, pituitary headaches could be primary or secondary and the current ICHD criteria do not define the headaches adequately. Based on the findings of the study, the authors suggest a revision of the International Classification of Headache Disorders (ICHD) diagnostic criteria with addition of an additional diagnostic category for headache attributed to pituitary disease.