Primary care direct access MRI for the investigation of chronic headache

Clin Radiol. 2012 Jan;67(1):24-7. doi: 10.1016/j.crad.2011.02.006. Epub 2011 Nov 16.


Aim: To assess the efficacy of a primary-care imaging pathway for neurology outpatients, from inception to deployment, compared with traditional outpatient referral.

Materials and methods: After local agreement, guidelines were generated providing pathways for diagnosis and treatment of common causes of headache, highlighting "red-flag" features requiring urgent neurology referral, and selecting patients for direct magnetic resonance imaging (MRI) referral. In addition, reports were clarified and standardized. To evaluate the efficacy of the access pathway, a retrospective sequential review of 100 MRI investigations was performed comparing general practitioner (GP) referral, with traditional neurology referral plus imaging, acquired before the pathway started.

Results: No statistically significant difference in rates of major abnormalities, incidental findings or ischaemic lesions were identified between the two cohorts. Reported patient satisfaction was high, with a cost reduction for groups using the pathway.

Conclusion: The findings of the present study suggest that a defined access pathway for imaging to investigate chronic headache can be deployed appropriately in a primary-care setting.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Critical Pathways
  • Female
  • Headache Disorders / diagnosis*
  • Humans
  • Infant
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Primary Health Care*
  • Retrospective Studies
  • Young Adult