Factors associated with incidental neuroimaging abnormalities in new primary headache patients

Byung Su Kim, Soo Kyoung Kim, Jae Moon Kim, Heui Soo Moon, Kwang Yeol Park, Jeong Wook Park, Jong Hee Sohn, Tae Jin Song, Min Kyung Chu, Myoung Jin Cha, Byung Kun Kim, Soo Jin Cho

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

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.

Original languageEnglish
Pages (from-to)222-229
Number of pages8
JournalJournal of Clinical Neurology (Korea)
Volume16
Issue number2
DOIs
StatePublished - Apr 2020

Keywords

  • Headache
  • Logistic models
  • Magnetic resonance imaging
  • Neuroimaging
  • Primary headache disorders

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