Psychiatry Investig.  2019 Jun;16(6):407-417. 10.30773/pi.2019.04.11.

Diagnostic Neuroimaging in Headache Patients: A Systematic Review and Meta-Analysis

Affiliations
  • 1Department of Psychiatry, Seoul National University of Bundang Hospital, Seongnam, Republic of Korea. quteray@naver.com
  • 2Department of Biostatistics, Korea University Graduate School, Seoul, Republic of Korea.
  • 3Department of Psychiatry, Chung-Ang University Medical Center, Seoul, Republic of Korea.

Abstract


OBJECTIVE
Neuroimaging in headache patients identifies clinically significant neurological abnormalities and plays an important role in excluding secondary headache diagnoses. We performed a systematic review and meta-analysis of the existing guidelines and studies surrounding neuroimaging in headache patients.
METHODS
The research question involved determining the prevalence of detecting clinically significant neurological abnormalities using neuroimaging in patients suspected of primary headache. Searches of the PubMed and Embase databases were conducted on English-language studies published from 1991 to 2016, and the reference lists of the retrieved articles were also checked manually. All headache subtypes and patients aged ≥15 years were included in the analysis.
RESULTS
Ten studies met the selection criteria. The pooled prevalence of detecting clinically significant abnormalities in the neuroimaging of headache patients was 8.86% (95% confidence interval: 5.12-15.33%). Subsequently, diverse subgroup analyses were performed based on the detection method, headache type, study type, study region, age group, and disease type.
CONCLUSION
The present findings indicate that limited neuroimaging methods should be carefully considered for headache diagnostic purposes when there are red flag symptoms. Limitations and suggested directions for future studies on neuroimaging in headache patients are described.

Keyword

Headache; Neuroimaging; X-ray computed tomography; Magnetic resonance imaging

MeSH Terms

Diagnosis
Headache*
Humans
Magnetic Resonance Imaging
Methods
Neuroimaging*
Patient Selection
Prevalence
Tomography, X-Ray Computed
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