Computed Tomography (CT) in A Headache Patient: Is Routine Evaluation Really Necessary?

Kajal Mitra, Chetna Ratnaparkhi, Glossy Sabharwal

Abstract


Objective: To determine the likelihood ratio of a positive computed tomogram of the brain in the routine
evaluation of headache patients.
Materials and method : This was a prospective study conducted in the Department of Radio-Diagnosis at NKP
Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur from April 2007 to September 2010,
in which consecutive patients with a chief complaint of headache were evaluated with computed tomography
of the brain.
Results: Consecutive sample of 760 patients with a chief complaint of headache, regardless of the presence
or absence of physical or neurologic signs, were referred for computed tomography of the brain. Out of the
total number of patients, 213 had computed tomographic findings that were clinically significant. All of the
patients with significant computed tomographic findings had an abnormal physical or neurologic exam or
unusual clinical symptoms.
Conclusion: Routine computed tomography of the brain in headache patients with normal physical and
neurologic exams and no unusual clinical symptoms has a low likelihood ratio for discovering significant
intracranial disease.
Key Words : Headache, CT scan, evaluation


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