title: Imaging results in a consecutive series of 530 new patients in the Birmingham Headache Service.
abstract: Guidelines recommend imaging only headache patients with sinister features in the history or on examination. We prospectively collected data on imaging newly presenting patients to a UK headache service. CT and MRI results were classified as normal or showing an insignificant or significant abnormality. Over 5 years, 3,655 new patients (69% female; mean age 42.0 years) with headache disorders were seen. Five hundred thirty (14.5%) underwent imaging with large differences in the proportion referred by each consultant. There were more insignificant abnormalities on MRI (46%) than CT (28%). There were 11 significantly abnormal results (2.1% of those imaged). Significant abnormalities were found in patients diagnosed with migraine in 1.2% and in 0.9% of those with tension-type headache. Significant abnormalities in those suspected to have an intracranial abnormality occurred in 5.5%. This supports the practice of selecting patients with suspicious findings for imaging, rather than imaging all patients.
authors.affiliation: School of Clinical and Experimental Medicine, College of Medicine and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK. c.e.clarke@bham.ac.uk
authors.forename: C E
authors.initials: CE
authors.lastname: Clarke
authors.forename: J
authors.initials: J
authors.lastname: Edwards
authors.forename: D J
authors.initials: DJ
authors.lastname: Nicholl
authors.forename: A
authors.initials: A
authors.lastname: Sivaguru
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D020773:Headache Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis / Q000453:epidemiology; D009421:Nervous System Malformations / Q000175:diagnosis / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012017:Referral and Consultation; D018781:Tension-Type Headache / Q000175:diagnosis / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology; D014657:Vasculitis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology