두통환자에 대한 방사선학적 검사의 진단적 가치

The Role of Radiologic Study in Diagnostic Work-up of Headache Patients

Objective : The goal of this study is to identify the significant radiologic abnormalities in patients complaining headache and to determine predictive factors for clinically significant radiological abnormalities. Method : The study population was 410 patients having underwent CT or MRI study among 1000 patients complaining headache in outpatient basis between 1996-1999. All of these patients answered self-administered questionaire about their headaches. We reviewed the patient's charts and the questionaires and examined the radiologic study results. Result : Of the 410 patients referred for CT or MRI study, male : female ratio was 1 : 1.97. Twenty-five patients(6.1%) revealed clinically significant organic lesions. Mean age was 46.1 in radiologic abnormal group and 48.4 in normal group. Short symptom duration(p<0.01), motor weakness(p<0.05), vomiting(p<0.05), cranial nerve palsy(p<0.05), and trauma history(p<0.05) were factors indicated higher incidence of radiologic abnormality. But, patients age, and severity of headache were not associated with clinically significant radiologic lesion. The ratio of radiologic abnormality was 0.8% in patients not having any risk factor. Conclusion : The results indicate that radiologic study should be done in headache patients having the risk factors such as short symptom duration, motor weakness, vomiting, cranial nerve palsy, trauma history. For patients without any such a risk factor, the radiologic study doesn't seem mandatory.