Wang H Z, Simonson T M, Greco W R, Yuh W T
Department of Radiology, University of Rochester Medical Center, NY 14642-8648, USA.
Acad Radiol. 2001 May;8(5):405-8. doi: 10.1016/S1076-6332(03)80548-2.
The authors investigated the use of magnetic resonance (MR) imaging of the brain in adult patients with a primary complaint of chronic headache and no other neurologic symptoms or findings and determined the yield and MR predictors of major abnormalities in these patients.
The medical records and MR images of 402 adult patients with chronic headache were retrospectively reviewed. All patients had been evaluated and referred by the neurology service. The findings were categorized as either negative or positive for major abnormality. Multivariate analysis with a linear logistic regression technique was performed on the clinical data, which included patient age, patient sex, and headache type.
Major abnormalities were found in 15 patients (3.7%), consisting of seven women (2.4%) and eight men (6.9%). Major abnormalities were found in 0.6% of those with migraine headaches, 1.4% with tension headaches, none with mixed migraine and tension headaches, 14.1% with atypical headaches, and 3.8% with other types of headaches. Multivariate analysis showed that the atypical headache type was the most significant predictor of major abnormality.
The yield of major abnormalities found with brain MR imaging in patients with isolated chronic headache is low. However, those patients with atypical headaches have a higher yield of major abnormalities and may benefit from imaging.
作者研究了以慢性头痛为主诉且无其他神经症状或体征的成年患者脑部磁共振成像（MR）的应用情况，并确定了这些患者主要异常情况的检出率及MR预测指标。
回顾性分析402例成年慢性头痛患者的病历及MR图像。所有患者均由神经科进行评估并转诊。检查结果分为主要异常阴性或阳性。对包括患者年龄、性别及头痛类型在内的临床数据进行线性逻辑回归技术的多变量分析。
15例患者（3.7%）发现主要异常，其中女性7例（2.4%），男性8例（6.9%）。偏头痛患者中0.6%发现主要异常，紧张性头痛患者中1.4%发现主要异常，偏头痛与紧张性头痛混合型患者未发现主要异常，非典型头痛患者中14.1%发现主要异常，其他类型头痛患者中3.8%发现主要异常。多变量分析显示非典型头痛类型是主要异常的最显著预测指标。
单纯慢性头痛患者脑部MR成像发现主要异常的检出率较低。然而，非典型头痛患者主要异常的检出率较高，可能从成像检查中获益。
