title: Prevalence of brain magnetic resonance imaging meeting Barkhof and McDonald criteria for dissemination in space among headache patients.
abstract: BACKGROUND
  Incidental T2 white matter hyperintensities (WMHs) in headache patients on brain magnetic resonance imaging (MRI) may prompt concern for demyelinating disease.
  
  
  OBJECTIVE
  We reviewed brain MRI studies in patients with headaches without known demyelinating disease to determine the prevalence meeting imaging criteria for multiple sclerosis (MS) using two different definitions of "juxtacortical" and "periventricular".
  
  
  METHODS
  Consecutive patients undergoing pre- and post-contrast MRI for headaches over a 25-month period were retrospectively identified. Exclusions included patients under age 10 and over 55 years or with known demyelinating disorder. Patients were classified as meeting: 1) Barkhof and 2) 2010 McDonald dissemination in space criteria for MS based on: FLAIR/T2 scans for WMH and enhanced T1-weighted images for enhancement. Both groups were further differentiated by defining "periventricular" and "juxtacortical" as WMH contacting ventricle and cortex (Barkhof "touching", McDonald "touching") versus WMH within 3 mm (Barkhof--3 mm, McDonald--3 mm).
  
  
  RESULTS
  326/564 (58%) studies met inclusion criteria. WMH prevalence was 168/326 (51.53%). Barkhof "touching" criteria were met in 4/168 (2.4%) and in 12/168 (7.1%) of the 3 mm group. McDonald criteria were met in 41/168 (24.4%) for "touching" and 58/168 (34.5%) for 3 mm, respectively.
  
  
  CONCLUSIONS
  Barkhof and McDonald criteria were met in 2.4-7.1% and 24.4-34.5%, respectively.
authors: School of Medicine, Oregon Health and Science University, Portland 97239, USA.
authors: Syrone
authors: S
authors: Liu
authors: Jonathan
authors: J
authors: Kullnat
authors: Dennis
authors: D
authors: Bourdette
authors: Jack
authors: J
authors: Simon
authors: Dale F
authors: DF
authors: Kraemer
authors: Charles
authors: C
authors: Murchison
authors: Bronwyn E
authors: BE
authors: Hamilton
mesh_terms: D000328:Adult; D005260:Female; D006261:Headache / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies
keywords: Multiple sclerosis; clinically isolated syndrome; fluid attenuation inversion recovery; magnetic resonance imaging; radiologically isolated syndrome; white matter hyperintensity