Types of Non-Acute Headache and Neuroimaging in the Evaluation of Patients with this Type of Headache
Abstract
The aim of this study was to find the type of non-acute headache and to estimate the frequency of significant intracranial lesions in this type of headache. Non-acute headache was defined as any type of headache that had begun at least four weeks before. All the patients aged > 15 years attending the neurology and neurosurgery clinics of Post Graduate Medical Institute (PGMI), Lady Reading Hospital (LRH) Peshawar with non-acute headache were included in the study. The pregnant women and patients with facial pain alone were excluded from the study. They were followed prospectively for over a year. Detailed history and through neurlogic exami-nation was performed. The headache was classified according to the International Classification of Headache Disorder (ICHD) second edition of the International Headache Society (IHS). Every patient was investigated by neuroimaging studies. The computed tomography (CT) was done in all patients. Magnetic resonance imaging (MRI) was done in 86 patients to improve their diagnosis. Neuroimaging results were classified as “significant abnormalities”, “non-significant abnormalities” or “normal”. Significant abnormalities included neoplastic disease, hydrocephalus, vascular malformations, chiari malformation, large aracnoid cysts, intracranial hemorrhage and acute cerebral infarcts. The total number of patients was 1200; 795 women and 405 men. Their mean age was 38 years (15-75 years). Neuroimaging studies detected significant lesions in 18 patients (1.5%). The proportion of patients with headache and intracranial lesions is relatively small but neither neurological examination nor the features in the clinical history permit us to rule out such abnormalities.
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