اداره و درمان سردردها بر اساس يافته هاي نوروراديولوژي

Management of headache based on neuroimaging

Since headaches is one of the most common medical complains , the general indications for neuroimaging in headache patients are still a matter of dispute. This study was performed in order to evaluate the role of neuroimaging in the management of the headache. A retrospective study was performed over the information collected from medical records of 500 headache patients presenting to tabriz Imam Khomeini and Razi hospitals in order to identification of the role of neuroimaging modalities in the management of patients with headache . It is revealed from this study that primary (without organic cause) and secondary headache (with an organic cause) constitute %9l .6 and %8.4 of cases , respectively, with the brain tumor being the most frequent pathology of 458 patients with primary headache, 70 cases underwent one of neuroimaging examinations such as CT Scan. All patients with secondary headaches ,also, underwent CT and the organic pathology was determined primarily by CT including brain tumor (25 cases), subarachnoid hemorrhage (9 cases), aneurysm(4 cases), subdural hematoma (3 cases) and one brain hydatid cyst. The next imaging modality used among above mentioned patients was MRI or angiography which has been requested in 12 and 2 patients , respectively. It is concluded that neuroimaging request must be restricted to patients with symptoms of elevated intracranial pressure and abnormal findings in neurological examination and those with headlache in associated with changes in intensity and quality.