J Korean Neurol Assoc.  2018 Nov;36(4):294-301. 10.17340/jkna.2018.4.4.

Neuroimaging Findings of First-Visit Headache Patients

Affiliations
  • 1Department of Neurology, Bundang Jesaeng General Hospital, Seongnam, Korea.
  • 2Department of Neurology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
  • 3Department of Neurology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea.
  • 4Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 5Department Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
  • 6Department of Neurology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea.
  • 7Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
  • 8Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.
  • 9Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 10Department of Neurology, National Police Hospital, Seoul, Korea.
  • 11Department of Neurology, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea. kbk1403@eulji.ac.kr
  • 12Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea. dowonc@naver.com

Abstract

BACKGROUND
Neuroimaging can play a crucial role in discovering potential abnormalities to cause secondary headache. There has been a progress in the fields of headache diagnosis and neuroimaging in the past two decades. We sought to investigate neuroimaging findings according to headache disorders, age, sex, and imaging modalities in first-visit headache patients.
METHODS
We used data of consecutive first-visit headache patients from 9 university and 2 general referral hospitals. The International Classification of Headache Disorders, third edition, beta version was used in headache diagnosis. We finally enrolled 1,080 patients undertook neuroimaging in this study.
RESULTS
Among 1,080 patients (mean age: 47.7±14.3, female: 60.8%), proportions of headache diagnosis were as follows: primary headaches, n=926 (85.7%); secondary headaches, n=110 (10.2%); and cranial neuropathies and other headaches, n=43 (4.1%). Of them, 591 patients (54.7%) received magnetic resonance imaging (MRI). Neuroimaging abnormalities were found in 232 patients (21.5%), and their proportions were higher in older age groups and male sex. Chronic cerebral ischemia was the most common finding (n=88, 8.1%), whereas 76 patients (7.0%) were found to have clinically significant abnormalities such as primary brain tumor, cancer metastasis, and headache-relevant cerebrovascular disease. Patients underwent MRI were four times more likely to have neuroimaging abnormalities than those underwent computed tomography (33.3% vs. 7.2%, p <0.001).
CONCLUSIONS
In this study, the findings of neuroimaging differed according to headache disorders, age, sex, and imaging modalities. MRI can be a preferable neuroimaging modality to identify potential causes of headache.

Keyword

Headache disorders primary; Headache disorders secondary; Neuroimaging; Magnetic resonance imaging

MeSH Terms

Brain Ischemia
Brain Neoplasms
Cerebrovascular Disorders
Classification
Cranial Nerve Diseases
Diagnosis
Female
Headache Disorders
Headache*
Humans
Magnetic Resonance Imaging
Male
Neoplasm Metastasis
Neuroimaging*
Referral and Consultation
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