Factors Associated with Incidental Neuroimaging Abnormalities in New Primary Headache Patients
10.3988/jcn.2020.16.2.222
- Author:
Byung-Su KIM
1
;
Soo-Kyoung KIM
;
Jae-Moon KIM
;
Heui-Soo MOON
;
Kwang-Yeol PARK
;
Jeong Wook PARK
;
Jong-Hee SOHN
;
Tae-Jin SONG
;
Min Kyung CHU
;
Myoung-Jin CHA
;
Byung-Kun KIM
;
Soo-Jin CHO
Author Information
1. Department of Neurology, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea.
- Publication Type:Original Article
- From:Journal of Clinical Neurology
2020;16(2):222-229
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:and PurposeDeciding whether or not to perform neuroimaging in primary headache is a dilemma for headache physicians. The aim of this study was to identify clinical predictors of incidental neuroimaging abnormalities in new patients with primary headache disorders.
Methods:This cross-sectional study was based on a prospective multicenter headache registry, and it classified 1,627 consecutive first-visit headache patients according to the third edition (beta version) of the International Classification of Headache Disorders (ICHD-3β). Primary headache patients who underwent neuroimaging were finally enrolled in the analysis. Serious intracranial pathology was defined as serious neuroimaging abnormalities with a high degree of medical urgency. Univariable and multivariable logistic regression analyses were conducted to identify factors associated with incidental neuroimaging abnormalities.
Results:Neuroimaging abnormalities were present in 170 (18.3%) of 927 eligible patients. In multivariable analysis, age ≥40 years [multivariable-adjusted odds ratio (aOR)=3.37, 95% CI=2.07–6.83], male sex (aOR=1.61, 95% CI=1.12–2.32), and age ≥50 years at headache onset (aOR=1.86, 95% CI=1.24–2.78) were associated with neuroimaging abnormalities. In univariable analyses, age ≥40 years was the only independent variable associated with serious neuroimaging abnormalities (OR=3.37, 95% CI=1.17–9.66), which were found in 34 patients (3.6%). These associations did not change after further adjustment for neuroimaging modality.
Conclusions:Incidental neuroimaging abnormalities were common and varied in a primary headache diagnosis. A small proportion of the patients incidentally had serious neuroimaging abnormalities, and they were predicted by age ≥40 years. These findings can be used to guide the performing of neuroimaging in primary headache disorders.
