Diagnostic value of neuroimaging in patients with primary headaches (original) (raw)

The Pain Clinic, 2006

Abstract

ABSTRACT Emergencies in headache, requiring prompt diagnosis and treatment, are frequently important issues for the physician. Neuroimaging with computed tomography and magnetic resonance in the differential diagnosis of headache emergencies is the major diagnostic tool. To determine the differential diagnostic contribution of the imaging techniques, 275 consecutive patients with migraine with or without aura, tension type headache and other types of headaches were included in this study. The diagnoses were based on the International Headache Society's (IHS-2004) criteria. Regardless of the clinical diagnosis, CT and/or MRI images were performed in all cases.Abnormal images were encountered in 9.9% (27 of 275) of patients with headache. These findings were serious in 14 cases and led to the diagnosis of lacunar infarct, vascular malformation, mass lesion, calcification, subarachnoidal hemorrhage and leptomeningitis, while they were nonspesific in the other 13 patients (cortical or cerebral artophy and small anatomical alterations). Mean age was significantly higher in the patients with positive radiological findings (p < 0.0001). Radiological findings were more frequent in patients with tension type headache.

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