Journal of the Korean neurological association (대한신경과학회지)

Korean Neurological Association (대한신경과학회)
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Neuroimaging Findings of First-Visit Headache Patients

두통 초진 환자에서 신경영상검사 소견

  • Kim, Byung-Su (Department of Neurology, Bundang Jesaeng General Hospital) ;
  • Kim, Soo-Kyoung (Department of Neurology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Kim, Jae-Moon (Department of Neurology, Chungnam National University Hospital, Chungnam National University College of Medicine) ;
  • Moon, Heui-Soo (Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Park, Kwang-Yeol (Department Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine) ;
  • Park, Jeong Wook (Department of Neurology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Sohn, Jong-Hee (Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Song, Tae-Jin (Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine) ;
  • Chu, Min Kyung (Department of Neurology, Severance Hospital, Yonsei University College of Medicine) ;
  • Cha, Myoung-Jin (Department of Neurology, National Police Hospital) ;
  • Kim, Byung-Kun (Department of Neurology, Eulji Hospital, Eulji University School of Medicine) ;
  • Cho, Soo-Jin (Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine)
  • 김병수 (분당제생병원 신경과) ;
  • 김수경 (경상대학교 의과대학 경상대학교병원 신경과) ;
  • 김재문 (충남대학교 의과대학 충남대학교병원 신경과) ;
  • 문희수 (성균관대학교 의과대학 강북삼성병원 신경과) ;
  • 박광렬 (중앙대학교 의과대학 중앙대학교병원 신경과) ;
  • 박정욱 (가톨릭대학교 의과대학 의정부성모병원 신경과) ;
  • 손종희 (한림대학교 의과대학 춘천성심병원 신경과) ;
  • 송태진 (이화여자대학교 의과대학 이대목동병원 신경과) ;
  • 주민경 (연세대학교 의과대학 세브란스병원 신경과) ;
  • 차명진 (경찰병원 신경과) ;
  • 김병건 (을지대학교 의과대학 을지병원 신경과) ;
  • 조수진 (한림대학교 의과대학 동탄성심병원 신경과)
  • Received : 2018.08.29
  • Accepted : 2018.09.20
  • Published : 2018.11.30
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Abstract

Background: Neuroimaging can play a crucial role in discovering potential abnormalities to cause secondary headache. There has been a progress in the fields of headache diagnosis and neuroimaging in the past two decades. We sought to investigate neuroimaging findings according to headache disorders, age, sex, and imaging modalities in first-visit headache patients. Methods: We used data of consecutive first-visit headache patients from 9 university and 2 general referral hospitals. The International Classification of Headache Disorders, third edition, beta version was used in headache diagnosis. We finally enrolled 1,080 patients undertook neuroimaging in this study. Results: Among 1,080 patients (mean age: $47.7{\pm}14.3$, female: 60.8%), proportions of headache diagnosis were as follows: primary headaches, n=926 (85.7%); secondary headaches, n=110 (10.2%); and cranial neuropathies and other headaches, n=43 (4.1%). Of them, 591 patients (54.7%) received magnetic resonance imaging (MRI). Neuroimaging abnormalities were found in 232 patients (21.5%), and their proportions were higher in older age groups and male sex. Chronic cerebral ischemia was the most common finding (n=88, 8.1%), whereas 76 patients (7.0%) were found to have clinically significant abnormalities such as primary brain tumor, cancer metastasis, and headache-relevant cerebrovascular disease. Patients underwent MRI were four times more likely to have neuroimaging abnormalities than those underwent computed tomography (33.3% vs. 7.2%, p<0.001). Conclusions: In this study, the findings of neuroimaging differed according to headache disorders, age, sex, and imaging modalities. MRI can be a preferable neuroimaging modality to identify potential causes of headache.

Keywords

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