Neuroimaging of Headache Disorders

This book is a volume in the series entitled Headache, edited by Paolo Martelletti and endorsed by the European Headache Federation. It is addressed to the medical specialities concerned with clinically diagnosing and managing patients suffering from headaches (rather than to radiologists). As such, it contains material either too basic for a radiologist (such as the principles of imaging modalities) or too detailed for them (such as the current state of research on migraine).

However, the comprehensive coverage of the many types of both primary and secondary headaches will aid understanding of the complexity of this symptom, which is such a common indication for performing neuroimaging. Of practical help is the concept of ‘green flags’, presented in the chapter ‘Neuroimaging of headache disorders in the emergency department’; for instance, the presence of headache-free days as indicative of primary headache disorders. It counter-balances the ‘red flags’ that are supposed to increase sensitivity of detecting the dreaded secondary headaches, but are so frequently overstated in imaging requests.

The relatively small number of radiological images are of good quality with clear annotations, but illustrate only a minority of the book’s 12 chapters, mostly just ‘Incidental neuroimaging abnormalities in patients with headache disorders’ and ‘Neuroimaging studies of painful lesions of the cranial nerves’. Tellingly, not a single radiological image is present in the chapters on different types of migraines. Familiarising yourself with the book will provide knowledge of the underlying pathophysiological processes, but would not be of much assistance in honing neuroradiology reporting skills.

The references are extensive but largely concerned with research topics.

This textbook attempts to bridge the gap between the simplistic clinical handling of headaches known all too well to radiologists, from the usual request for ‘Headache,?bleed ?SOL’, and the vast pathophysiological complexity behind this very common and disabling symptom. The message from the authors is clear: we are a long way from being able to bridge that gap, and the hope lies in applying machine learning and a big data approach.

To purchase this title at our discounted rate email: katherine@radmagazine.com.