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J Neurol. 2010 Aug;257(8):1274-8. doi: 10.1007/s00415-010-5506-7. Epub 2010 Mar 3.

Imaging results in a consecutive series of 530 new patients in the Birmingham Headache Service.

Author information

1
School of Clinical and Experimental Medicine, College of Medicine and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK. c.e.clarke@bham.ac.uk

Abstract

Guidelines recommend imaging only headache patients with sinister features in the history or on examination. We prospectively collected data on imaging newly presenting patients to a UK headache service. CT and MRI results were classified as normal or showing an insignificant or significant abnormality. Over 5 years, 3,655 new patients (69% female; mean age 42.0 years) with headache disorders were seen. Five hundred thirty (14.5%) underwent imaging with large differences in the proportion referred by each consultant. There were more insignificant abnormalities on MRI (46%) than CT (28%). There were 11 significantly abnormal results (2.1% of those imaged). Significant abnormalities were found in patients diagnosed with migraine in 1.2% and in 0.9% of those with tension-type headache. Significant abnormalities in those suspected to have an intracranial abnormality occurred in 5.5%. This supports the practice of selecting patients with suspicious findings for imaging, rather than imaging all patients.

PMID:
20198381
DOI:
10.1007/s00415-010-5506-7
[Indexed for MEDLINE]

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