AIM: to evaluate MRI and CT findings in children and adults presenting with headaches and to define the value of these methods in the diagnostics of headaches. MATERIALS/ METHODS: 164 children and 317 adults with headaches were included in the trial. In all cases either MRI or CT was performed depending on the specialist's referral or the patient's request in case of MRI. RESULTS: in the group of children 40.9% showed no abnormalities on neuroimaging. The results with abnormal features have been considered as 'positive' and divided in two groups: 'significant' lesions requiring further diagnostic procedures or urgent neurosurgery and 'benign' lesions, where patient management did not change. In 2.4% 'significant' lesions were found. The remaining 56.7% had 'benign' lesions diagnosed (16 abnormalities occurring alone or in combination). Among the adults 67.5% had normal MRI or CT scans. In 32.5% neuroimaging revealed abnormalities: 2.2% described as 'significant' lesions and 30.3% described as 'benign' lesions. CONCLUSIONS: 1. Neuroimaging methods (MRI and CT) should not be routinely ordered in the initial diagnostics of headaches. 2. Patients suspected of neoplastic disease, vascular malformations, posttraumatic lesions or focal brain lesions must have these examinations performed. 3. The percentage of patients with headaches who require such extended diagnostics with MRI or CT is low.
AIM: to evaluate MRI and CT findings in children and adults presenting with headaches and to define the value of these methods in the diagnostics of headaches. MATERIALS/ METHODS: 164 children and 317 adults with headaches were included in the trial. In all cases either MRI or CT was performed depending on the specialist's referral or the patient's request in case of MRI. RESULTS: in the group of children 40.9% showed no abnormalities on neuroimaging. The results with abnormal features have been considered as 'positive' and divided in two groups: 'significant' lesions requiring further diagnostic procedures or urgent neurosurgery and 'benign' lesions, where patient management did not change. In 2.4% 'significant' lesions were found. The remaining 56.7% had 'benign' lesions diagnosed (16 abnormalities occurring alone or in combination). Among the adults 67.5% had normal MRI or CT scans. In 32.5% neuroimaging revealed abnormalities: 2.2% described as 'significant' lesions and 30.3% described as 'benign' lesions. CONCLUSIONS: 1. Neuroimaging methods (MRI and CT) should not be routinely ordered in the initial diagnostics of headaches. 2. Patients suspected of neoplastic disease, vascular malformations, posttraumatic lesions or focal brain lesions must have these examinations performed. 3. The percentage of patients with headaches who require such extended diagnostics with MRI or CT is low.
Authors: Joseph Prandota; Anna Gryglas; Aleksander Fuglewicz; Agata Zesławska-Faleńczyk; Barbara Ujma-Czapska; Leszek Szenborn; Janusz Mierzwa Journal: World J Clin Pediatr Date: 2014-08-08