¿Se abusa de las técnicas de neuroimagen en pacientes con migraña crónica? Estudio en un área de salud del Principado de Asturias

Abstract

There is a general perception of neuroimaging procedures overuse, mainly of CT scan, in patients with headache in Spain. To analyze the use of neuroimaging techniques, mainly CT scan as it is of free access in our region, in routine clinical practice in patients with chronic migraine (CM). We reviewed the medical records of a consecutive series of women diagnosed as CM in our headache clinic. The data on consumption of neuroimaging procedures were collected at all levels (emergency department, inpatient ward and neurologic outpatient consultation). We included 139 women with CM. A total of 106 patients (76%) had at least one CT brain scan. Twenty-eight patients (20%) had 2 or more CT scans. In 6 of these patients (21%) there was a clinical reason for repeating the studies, while there was no reason in the remaining 22 (79%). MRI had been carried out in our headache clinic in 59 patients (42%). In 43 (73%) MRI was normal, in 9 (15%) the MRI showed nonspecific lesions in the white matter and in 7 patients (11%) MRI studies were abnormal. There was no direct relationship between MRI lesion and CM. There were 15 patients with CM (11%) without any neuroimaging study. We could not find a real overuse of neuroimaging techniques in patients with CM in our health area.