Imaging results in a consecutive series of 530 new patients in the Birmingham Headache Service

J Neurol. 2010 Aug;257(8):1274-8. doi: 10.1007/s00415-010-5506-7. Epub 2010 Mar 3.


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.

MeSH terms

  • Adult
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / epidemiology
  • Female
  • Headache Disorders / diagnosis*
  • Headache Disorders / epidemiology*
  • Humans
  • Male
  • Middle Aged
  • Migraine Disorders / diagnosis
  • Migraine Disorders / epidemiology
  • Nervous System Malformations / diagnosis
  • Nervous System Malformations / epidemiology
  • Prevalence
  • Prospective Studies
  • Referral and Consultation
  • Tension-Type Headache / diagnosis
  • Tension-Type Headache / epidemiology
  • United Kingdom / epidemiology
  • Vasculitis / complications
  • Vasculitis / diagnosis
  • Vasculitis / epidemiology