Factors Associated with Incidental Neuroimaging Abnormalities in New Primary Headache Patients
Year: 2020
Type: article
Study design: Observational Study
Abstract: BACKGROUND AND PURPOSE: Deciding whether or not to perform neuroimaging in primary headache is a dilemma for headache physicians. The aim of this study was to identify clinical predictors of incidental neuroimaging abnormalities in new patients with primary headache disorders. METHODS: This cross-sectional study was based on a prospective multicenter headache registry, and it classified 1,627 consecutive first-visit headache patients according to the third edition (beta version) of the International Classification of Headache Disorders (ICHD-3β). Primary headache patients who underwent neuroimaging were finally enrolled in the analysis. Serious intracranial pathology was defined as serious neuroimaging abnormalities with a high degree of medical urgency. Univariable and multivariable logistic regression analyses were conducted to identify factors associated with incidental neuroimaging abnormalities. RESULTS: Neuroimaging abnormalities were present in 170 (18.3%) of 927 eligible patients. In multivariable analysis, age ≥40 years [multivariable-adjusted odds ratio (aOR)=3.37, 95% CI=2.07-6.83], male sex (aOR=1.61, 95% CI=1.12-2.32), and age ≥50 years at headache onset (aOR=1.86, 95% CI=1.24-2.78) were associated with neuroimaging abnormalities. In univariable analyses, age ≥40 years was the only independent variable associated with serious neuroimaging abnormalities (OR=3.37, 95% CI=1.17-9.66), which were found in 34 patients (3.6%). These associations did not change after further adjustment for neuroimaging modality. CONCLUSIONS: Incidental neuroimaging abnormalities were common and varied in a primary headache diagnosis. A small proportion of the patients incidentally had serious neuroimaging abnormalities, and they were predicted by age ≥40 years. These findings can be used to guide the performing of neuroimaging in primary headache disorders.
Source: Journal of Clinical Neurology
Institutions: Eulji University, Bundang Jesaeng Hospital, Eulji Medical Center, Gyeongsang National University, Gyeongsang National University Hospital, Chungnam National University, Kangbuk Samsung Hospital, Sungkyunkwan University, Chung-Ang University Hospital, Chung-Ang University Healthcare System, Chung-Ang University, The Catholic University of Korea Uijeongbu St. Mary's Hospital, Catholic University of Korea, Hallym University, Hallym University Chuncheon Sacred Heart Hospital, Ewha Womans University, Ewha Womans University Seoul Hospital, Yonsei University, Severance Hospital, National Police Hospital, Hallym University Dongtan Sacred Heart Hospital
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W3013328437