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Headache-Related Neuroimaging
Aka: Headache-Related Neuroimaging, Neuroimaging in Headache
- See Also
- Headache
- Headache Causes
- Headache Examination
- Headache Diagnostic Testing
- Headache Red Flags
- Indications: Head Imaging (typically MRI Brain with and without contrast)
- See Headache Red Flags
- Trigeminal autonomic Cephalgia (Cluster Headache, Paroxysmal Hemicrania, Hemicrania Continua, SUNCT Syndrome)
- Headache with new features or neurologic deficits
- Suspected intracranial abnormality
- Chronic Progressive Headache over weeks to months
- Neuroimaging recommended for organic Headache Evaluation, but yield is 1%
- Protocol: Imaging selection
- Immunocompromised
- MRI Head with and without contrast
- Temporal Arteritis suspected in age >60 years
- MRI Head with and without contrast
- Requires starting Corticosteroids and obtaining temporal artery biopsy
- Suspected Meningitis
- CT Head or MRI Head without contrast
- Start antibiotics and obtain Lumbar Puncture
- Pregnancy and severe Headache
- MRI Head (preferred) or CT Head
- Suspected carotid dissection with severe unilateral Headache
- MRI Head with and without contrast and MRA of the head and neck OR
- CTA head and neck
- Sudden onset severe Headache (first or worst, thunderclap)
- CT Head without contrast followed by CTA Head or Lumbar Puncture or
- MRI Head with and without contrast and MRA Head
- References
- Strain (2000) Radiology 215(suppl):855-60 [PubMed]
- Douglas (2014) J Am Coll Radiol 11(7): 657-67 [PubMed]