A study conducted by the Department of Pediatrics, Chosum University Hospital in Korea examined the role of neuroimaging in children and adolescents with recurrent headaches. This study is outlined in the March 2011 issue of Headache. Neuroimaging studies are commonly performed in patients with headache because of increasing demands by parents and physicians, although objective data and studies to support this widespread practice are minimal.
This study reviewed the medical records of 1562 patients presenting with recurrent headaches to 9 Neurology Clinics. The International Classification of Headache Disorders was used to classify headache types.
These records showed that neuroimaging procedures were performed in 77.1% of the patients. Indications for neuroimaging included abnormal neurological examination, recent onset of severe headache, change in type of headache, and neurologic dysfunction and demands of parents or physicians. The percentage of abnormal findings was 2.3% in CT, 8.6% in MRI, and 17.6% in MRI and magnetic resonance angiogram. Eleven patients underwent surgery based on neuroimaging findings, however none of the patients underwent neuroimaging because of change in the type of headache and demands of parent or
physicians.
Based on these findings, the study suggests that educating parents regarding the role of neuroimaging is needed. Additionally increasing physicians’ awareness regarding the utility of practice guidelines and the risk of neuroimaging procedures are needed to curb its overuse. Furthermore, the study researchers believe that neuroimaging study should remove “change in type of headache” from the official guidelines in children.