Are secondary descriptors of headache useful in neuroimaging examinations? Results of a multicenter retrospective study of 1041 brain MRI studies

Abstract

Headache is a common health problem in the general population. In clinical practice it is common to request neuroimaging examinations to rule out secondary headache, especially brain magnetic resonance imaging (MRI). The aim of this study is to analyze the secondary descriptors of headache-associated symptoms in brain MRI studies to assess their usefulness as predictors of potential intracranial structural abnormalities. Retrospective observational study of brain MRI studies performed due to headache in 6 centers in Andalusia between January 1 and May 30, 2019. The studies were performed on MRI machines with similar technical characteristics and imaging protocols, and were subjected to double reading by two neuroradiologists. Uni- and bivariate analyses were performed on the variables of interest: age, sex, headache-associated symptoms, and imaging findings. A total of 1041 patients who underwent brain MRI were included -mean age: 38.6 years (range: 3-86); 69.9% women-. In 737 (70.80%) cases there were no headache-associated symptoms and in the remaining patients (304 cases, 29.20%) there were headache-associated symptoms, the most frequent being: visual alterations, paresthesia, and vertigo and dizziness. Bivariate analyses showed no significant differences between groups. The findings of this study suggest that symptoms accompanying headache are not associated with a greater or lesser detection of intracranial structural abnormalities in MRI. Prospective studies that overcome the limitations of the present work are needed to verify this hypothesis.