Systematic review and meta-analysis finds higher intracranial aneurysm prevalence in pituitary adenoma patients

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Pituitary Published May 17, 2026 Medically reviewed May 17, 2026 Study authors: Marino Picciola Valentino, Borghesi Michela, Trombin Vanessa, Chirico Serena, Ambrosio Maria Rosaria… PubMed ↗ DOI ↗ By Dr. Julia Lee, PhD · Oncology, Genomics & Drug Development

Key Takeaway

Consider screening for intracranial aneurysms in patients with pituitary adenomas, given a 4% pooled prevalence and higher risk versus the general population.

This systematic review and meta-analysis examined the prevalence of intracranial aneurysms (IAs) in patients with pituitary adenomas (PAs). The analysis included two groups: 74 patients with both conditions (Group 1) and 5264 PA patients from pooled studies (Group 2). In Group 1, PAs were predominantly macroadenomas (91.9%) and most frequently non-functioning (40.5%), with IAs mainly located in the cavernous segment of the internal carotid artery (33%). The pooled prevalence of IAs among PA patients in Group 2 was 4% (95% CI 2-4%), with significant heterogeneity (I²=92.1%, τ²=1.1050, p<0.0001). Sex-stratified analysis showed a prevalence of 8% in females (95% CI 6%-9%) and 6% in males (95% CI 4%-7%). Compared with the general population, IA prevalence was significantly higher in both male and female PA patients (p<0.01). The authors note high heterogeneity as a key limitation, cautioning against overinterpretation of the pooled estimate. Clinically, the findings suggest that patients with PAs may warrant screening for IAs, but the association is not causal and the heterogeneity limits generalizability.

Study Details

Study typeMeta analysis

Sample sizen = 74

EvidenceLevel 1

PublishedMay 2026

PMID42142200

View Original Abstract ↓

PURPOSE: Intracranial aneurysms (IAs) and Pituitary Adenoma (PA) coexistence has been reported for decades, yet available evidence remains fragmented. We performed a systematic review and meta-analysis following PRISMA 2020 guidelines to assess clinical features of patients with both conditions and quantify the prevalence of IAs in PA patients. METHODS: PubMed and Embase were searched up to December 15, 2025. Studies reporting coexistence of IAs and PAs were included. Individual patient-level data (Group 1) and aggregate prevalence data (Group 2) were analyzed separately. Risk of bias (RoB) was assessed using Joanna Briggs Institute tools. All analyses were performed using metaprop function from the meta package in R software. RESULTS: Seventy-one studies met inclusion criteria. Most studies have a low RoB. In Group 1 (74 patients), PAs were predominantly macroadenomas (91.9%), most frequently non-functioning (40.5%). IAs were mainly in the cavernous segment of the internal carotid artery (33%). IA diagnosis occurred significantly later than PA diagnosis (p < 0.01). In Group 2 (5264 patients), the pooled prevalence of IAs among PAs was 4% (95% CI 2-4%; I² = 92.1%, τ² = 1.1050, p < 0.0001). Sex-stratified prevalence was 8% (95% CI: 6%-9%) in females and 6% (95% CI: 4%-7%) in males. IAs sex-specific prevalence was significantly higher in both male and female PA patients as compared to the general population (p < 0.01). CONCLUSION: Patients with PAs show a higher IAs prevalence compared with the general population, likely reflecting combined hemodynamic, anatomical, and endocrine influences.