Abstract
Headache is a common symptomatology necessitating hospital consultations. Despite the prohibitive cost to patients in Nigeria, Magnetic resonance imaging (MRI) has become an evaluating tool for headache. To determine the yield of cranial MRI and frequency of significant intracranial lesions among patients with chronic headache. A three-year retrospective analysis of cranial MR images and records of patients referred to Medicaid Diagnostic Centre in Abuja, Nigeria on account of chronic headache was done. Data was analyzed using SAS software version 9.3. 150 patients aged 9 to 73 years (mean= 39.5 years) with chronic headache were studied. There were 54 males and 96 females with a ratio of 1:1.8. 48% and 52% had normal and abnormal MRI findings respectively. Although the number with abnormal MRI was higher than those with normal exams, this difference was not significant (p=0.624). The commonest neoplastic and non-neoplastic abnormalities were pituitary macroadenoma (4%) and sinusitis (21.3%) respectively. In our study, MRI had a low diagnostic yield in patients with chronic headache. Therefore, it is expedient that physicians stratify patients with chronic headache based on red flag signs to determine the need for cranial MRI in view of financial burden.
Highlights
Headache is ranked among the ten most disabling conditions worldwide according to World Health Organization, (WHO) parameters.[1]
Multiplanar brain images on various sequences- T1-weighted (T1W; TE- 20ms, TR- 240ms), Gadolinium diethylenetriaminepentacetate (Gd-DTPA) - enhanced T1W (TE- 20ms, TR- 240ms), T2-weighted (T2W; TE- 120ms, TR- 3800ms), Fluid-attenuated Inverse Recovery (FLAIR; TE- 100ms, TR- 6600ms) and Magnetic Resonance Angiography (MRA)- were used for evaluation. 7mm-thick slices with a field of view (FOV) of 240mm were utilized for all sequences and planes
There was a significant difference between the ages of patients who had normal and abnormal Magnetic resonance imaging (MRI) yields (P= 0.0006)
Summary
Headache is ranked among the ten most disabling conditions worldwide according to World Health Organization, (WHO) parameters.[1]. Aetiologies of secondary headaches range from extra-cranial benign conditions such as sinusitis or mastoiditis to life-threatening intracranial pathology like subarachnoid haemorrhage or brain. Despite the prohibitive cost to patients in Nigeria, Magnetic resonance imaging (MRI) has become an evaluating tool for headache. Objectives: To determine the yield of cranial MRI and frequency of significant intracranial lesions among patients with chronic headache. Methods: A three-year retrospective analysis of cranial MR images and records of patients referred to Medicaid Diagnostic Centre in Abuja, Nigeria on account of chronic headache was done. Conclusion: In our study, MRI had a low diagnostic yield in patients with chronic headache. It is expedient that physicians stratify patients with chronic headache based on red flag signs to determine the need for cranial MRI in view of financial burden.
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