Magnetic resonance imaging (MRI) findings in referred adult patients with headache
DOI:
https://doi.org/10.15218/zjms.2024.40Keywords:
Secondary headache, MRI, Red flag, Cerebral tumors, SinusitisAbstract
Background and objective: Since the beginning of the medical practice, headache was considered both a therapeutic and a diagnostic challenge. According to the ranking that was made by the global burden of diseases collaborative network for causes of disabilities, headache was considered the fourth for both males and females. The aim of the study was to evaluate the findings of MRI among headache patients.
Methods: A cross-sectional study was conducted from 1st of Nov. 2021 till the 1stof June 2022. A convenient sample was collected from referred patients to outpatient clinic in Rizgary Teaching Hospital. The cases were diagnosed by a specialist in internal medicine and then referred for further MRI evaluation. The data analyzed using IBM SPSS (statistical package of social science) version 25. The data was summarized by descriptive statistics. The measures of central tendency and dispersion were calculated. The mean of age differences was calculated by t-test. The associations between categorical variables were found by Chi-square test. The P value was considered significant if it was ≤ 0.05.
Results: Out of 150 patients, 70% were females and only 30% were males with male to female ratio of. 0.43:1.73.3% of females in primary group had normal MRI findings and 84.4% of males had abnormal findings in the secondary group. The difference was statistically significant (P-value <0.001). The mean age ± SD for males was 45.2 ± 9.3 and the mean age for females was 37± 9.8. The difference between means was significant (P = 0.018). In MRI findings 56% (84 out of 150) of patients were normal, followed by sinusitis (28%), (3.3%) cerebral tumor,0.6% had pituitary mass and 0.6% diagnosed as meningitis.
Conclusion: The low rate of positive findings in our study supports the need for an evidence-based guideline for neuroimaging in this health care setting. Future studies are recommended to investigate other physicians’ reasons for using neuroimaging techniques as a routine investigation for headache patients.
Metrics
References
Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2019 (GBD 2019) Cause List Mapped to ICD Codes. Seattle, United States of America: Institute for Health Metrics and Evaluation (IHME) 2020. Available from: https://ghdx.healthdata.org/record/ihme-data/gbd-2019-cause-icd-code-mappings
GBD (2019) Diseases and injuries collaborators (2020) global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the global burden of disease study 2019. Lancet 2020; 396(10258):1204–22. Available from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30925-9/fulltext
Muneer A, Farooq A, Farooq JH, Qurashi MS, Kiani IA, Farook JS. Frequency of Primary Headache Syndromes in Patients with a Major Depressive Disorder. Cureus 2018; 10(6), e2747. doi: 10.7759/cureus.2747
Rabiee B, Zeinoddini A, Kordi R, Yunesian M, Mohammadinejad P, Mansournia MA. The Epidemiology of Migraine Headache in General Population of Tehran, Iran. Neuroepidemiology 2016; 46(1):9–13. doi: 10.1159/000441146
Hagen K, Åsberg AN, Uhlig BL, Tronvik E, Brenner E, Stjern M et al. The epidemiology of headache disorders: a face-to-face interview of participants in HUNT4. J Headache Pain 2018; 19(1):25. doi: 10.1186/s10194-018-0854-2
Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018; 38(1):1–211. Available from: https://pubmed.ncbi.nlm.nih.gov/29368949/.
Jang YE, Cho EY, Choi HY, Kim SM, Park HY. Diagnostic Neuroimaging in Headache Patients: A Systematic Review and Meta-Analysis. Psychiatry Investig 2019; 16(6):407–17. doi: 10.30773/pi.2019.04.11
Polat C, Baykara M, Yüce S, Uysal Ö, Dogan M. Prevalence of sinusitis and mastoiditis in headache. J Med Updates 2013; 3(3):146–9. doi: 10.2399/jmu.2013003008
Comelli I, Lippi G, Campana V, Servadei F, Cervellin G. Clinical presentation and epidemiology of brain tumors firstly diagnosed in adults in the Emergency Department: a 10-year, single center retrospective study. Ann Transl Med 2017; 5(13):269. doi: 10.21037/atm.2017.06.12
Carville S, Padhi S, Reason T, Underwood M. Diagnosis and management of headaches in young people and adults: summary of NICE guidance BMJ 2012; 345:e5765. doi: 10.1136/bmj.e5765
Alons IM, van den Wijngaard IR, Verheul RJ, Lycklama à Nijeholt G, Wermer MJ, Algra A, et al. The value of CT angiography in patients with acute severe headache. Acta Neurol Scand 2015; 131:164–8. doi: 10.1111/ane.12302
Sandrini G, Friberg L, Coppola G, Jänig W, Jensen R, Kruit M, et al. Neurophysiological tests and neuroimaging procedures in non-acute headache (2nd edition) Eur J Neurol 2011; 18:373–81. doi: 10.1111/j.1468-1331.2010.03212.x
Canêo, Luiz Fernando, and Rodolfo Neirotti. “The Importance of the Proper Definition of Adulthood: What is and What is Not Included in a Scientific Publication.” Brazilian journal of cardiovascular surgery 2017; 32(1):60. doi: 10.21470/1678-9741-2016-0049
Do TP, Remmers A, Schytz HW, Schankin C, Nelson SE, ObermannM,et al. Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list. Neurology. 2019; 92(3):134–44. doi: 10.1212/WNL.0000000000006697
Young NP, Elrashidi MY, McKie PM, Ebbert JO. Neuroimaging utilization and findings in headache outpatients: Significance of red and yellow flags. Cephalalgia 2018; 38(12):1841–48. doi: 10.1177/0333102418758282
Wang R, Liu R, Dong Z, Su H, Ao R, Liu Y, et al. Unnecessary Neuroimaging for Patients with Primary Headaches. Headache. 2019; 59(1):63–8. doi: 10.1111/head.13397
Onwuekwe I, Onyeka T, Aguwa E, Ezeala-Adikaibe B, Ekenze O, Onuora E. Headache prevalence and its characterization amongst hospital workers in Enugu, South East Nigeria. Head Face Med 2014; 10(5):48. doi: 10.1186/1746-160X-10-48
Ukamaka DI, Adaoroh AO. Computed tomographyimaging features of chronic Headaches in Abuja, Nigeria. Asian J Med Health 2017; 5:1–8. doi: 10.9734/AJMAH/2017/34713
Ogolodom MP, Mbaba AN, Abam R, Maduka BU, David LK, Alazigha N, et al. Magnatic Resonance Imaging Findings in patients presented with Headache in Port Harcourt, Rivers State, Nigeria. J Biomedical Sci 2019; 8(3):13.
Atcı İ., AlbayrakS, Yılmaz H. Neuroimaging of Patients with Headache in the Emergency Room: A Retrospective Analysis. Cukurova Medical Journal 2015; 40:86–90. doi: 10.17826/cutf.05573
Cain MR, Arkilo D, Linabery AM, Kharbanda AB. Emergency Department Use of Neuroimaging in Children and Adolescents Presenting with Headache. J Pediatr 2018; 201:196–201. doi: 10.1016/j.jpeds.2018.05.023
Yan PF, Yan L, Zhang Z, Salim A, Wang L, Ting Hu T et al. Accuracy of conventional MRI for preoperative diagnosis of intracranial tumors: A retrospective cohort study of 762 cases. Int J Surg 2016; 36:109–17. doi: 10.1016/j.ijsu.2016.10.023
Simpson GC, Forbes K, Teasdale E, Tyagi A, Santosh C. Impact of GP direct-access computerized tomography for the investigation of chronic daily headache. Br J Gen Pract 2010; 6(581):897–901. doi: 10.3399/bjgp10X544069
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Hiba Khalid Salih, Dildar A. Salih (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in Zanco J Med Sci is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0).
