Role of computed tomography for evaluation of headache without neurological deficit in tertiary care hospitals of Bangladesh

Abstract

Introduction: Headache is one of the most common complaints in patients pushing them for medical attention in the depart of emergency medicine and neurology clinic. Computed Tomography (CT) scan has a low yield value in patients with primary headaches without any neurological deficit. No national or international guidelines have been established yet for the clinical indication of neuroimaging. The main aim of our study is to determine the role of CT imaging in diagnosing a patient presented with a headache and evaluate the context of CT prescription in developing countries versus developed countries. Methodology: This study was a multicentric Retrospective study carried out from the data collected from Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) from 2017-2019 AD. A total of 2184 patients were included in the study who were requested for CT scans by their primary care physician. Collected data was entered and analyzed through the SPSS version 21 and Microsoft Excel 2021. Result: The total number of patients was 2184 with a predominance of females (63.02%) against males (36.98%) with a ratio of 1.7:1. CT scan findings were normal in 2060 cases which comprise 94.3 %, and positive in 124 cases accounting 5.7 % of the total study. The maximum number of cases was found in the age group between 21-30 years with 772 cases (35.3%) followed by the age group 31-40 years with 474 cases (21.7%), age group 11-20 years with 368 cases (16.8%), age group 41-50 years with 321 cases (14.67%), Age group 51-60 years with 131 cases (5.97%), age group 0-10 years with 83 cases (3.80%) and the least number of cases of 35 (1.67%) at the age group between 61-70 years. Conclusion: Computed Tomography y has a low yield value in the diagnostic evaluation of patients with headaches who had no focal neurological signs. Its overuse can cause a socio-economic burden on the patients including radiation hazards. Thus, it is not justifiable for patients with low to middle-income resource countries.