Clinical warning criteria in evaluation by computed tomography the secondary neurological headaches in adults.
Our aims were to investigate the frequency of intracranial lesions detected by cranial computed tomography (CT-scan) amongst adult patients who had clinical warning criteria (CWC) for secondary neurological headaches and to determine the importance of CWC in predicting a possible lesion on CT-scan. Seventy consecutive patients with headache exhibiting CWC were included in this prospective study. The CWC included: (i) increase in the intensity and frequency of headache; (ii) abrupt onset of headache; (iii) persistence of headache despite analgesics; (iv) alteration of the characteristics of headache; and (v) presence of focal neurological symptoms or findings. The mean age of the patients was 46.5 years; the female-to-male ratio was 1.5. Of the patients, 35.7% had a neurological cause identified by CT-scan, and 64.3% had normal CT-scan. In the patients without lesion, of headaches, 64.4% were primary, and 35.6% were from undefined headache group. Although, of the above criteria, only the 5th was different markedly in the patients with lesion than the patients without lesion, in evaluation by CT-scan the secondary neurological headaches in adults, all CWC should look for absolutely in their history and physical examination.
Aygun
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Department of Emergency Medicine, Medical School, Ondokuz Mayis University, Samsun, Turkey. daygun@omu.edu.tr
Bildik
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics; D001927:Brain Diseases / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D004196:Disease Outbreaks; D018450:Disease Progression; D004361:Drug Tolerance; D005260:Female; D006261:Headache / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*
D000700:Analgesics