PP15.11 – 3031: Brain magnetic resonance imaging findings in children with recurrent headache

Abstract

Objective To describe the frequency of abnormal findings detected on magnetic resonance imaging (MRI) in children with recurrent headache and to determine the prevalence and significance of nonspesific white matter lesions. Methods Children who were admitted to our pediatric outpatient neurology department with the complaint of recurrent headache between July 2013 and December 2014 were included in the study. We retrospectively reviewed the clinical and neuroimaging data of the patients. The types of headache were classified according to the criteria of International Headache Society. Results A total of 478 patients (273 female, 205 male) were included in the study. The types of headache were migraine in 218 (45.6%), tension-type in 159 (33.3%), secondary in 39 (8.2%) and unspecified headaches in 62 (13%) patients. MRI were performed in 407 (85%) patients and were abnormal in 145 (35%) patients. Eighteen patients had abnormal MRI findings related with headache, 13 of them had sinusitis, the other 5 (3%) had tumors. None of these 5 patients with tumor had abnormal neurologic symptoms or signs. Among the 127 patients, the most common findings were 42 cases of nonspecific white matter abnormalities, 17 cases of enlarged perivasculer spaces, 16 cases of asymmetric ventricles, 17 cases of arachnoid cyst, 12 cases with chiari type 1 and cerebellar tonsillar ectopia. The half of the patients with nonspecific white matter abnormalities had migrane, but no difference between the frequency of nonspecific white matter abnormalities in migraine and the other types of patients was found (p=0.55). Conclusion Due to the demands of the parents, the usage of neuroimaging studies in children with headache is increasing. Despite the increase in neuroimaging studies, the contribution of brain MRI in the diagnosis and the management of the children with recurrent headache is still low.