The added value of MRI brain for patients presenting with headache who have a normal unenhanced CT

Author(s): Fiona Choi, Dr G Pears, Dr H Wieshmann

Hospital: Liverpool University Hospitals NHS Foundation Trust

Reference: RAD Magazine, 49, 574, 18


Headaches are the most common neurological presenting complaint and affect up to half of the world’s population. Current guidelines suggest conducting either a CT or MR scan to identify intracranial pathology. Of course, not all patients experiencing headaches require neuroimaging; the investigations are costly, time consuming and would unnecessarily expose patients to radiation. Primary headache diseases including migraine, tension-type headaches and cluster headaches, are not associated with primary pathology and would not normally require neuroimaging. On the contrary, in patients who have additional abnormal neurological examination findings, there is a high positive predictive value for underlying intracranial pathology.

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