Neuroscience Clinic and First Scan Radiology Department, First Clinic, Jeddah, Saudi Arabia.
Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia; Department of Neurology and Neurosurgery, McGill University-Montreal Neurological Hospital and Institute, Montreal, Quebec, Canada.
Clin Neurol Neurosurg. 2020 Sep;196:106019. doi: 10.1016/j.clineuro.2020.106019. Epub 2020 Jun 18.
Migraine is one of the most common complaints encountered in neurology clinics. Accurate diagnoses of migraine are usually informed by the patient's history, and neuroimaging is only performed in cases of atypical or severe, medically intractable headache to rule out underlying pathologies. Our study aimed to identify the spectrum of brain magnetic resonance imaging (MRI) findings characteristic of chronic headache.
This retrospective study of adult patients referred to the First Scan radiology clinic in Jeddah, Saudi Arabia, for brain MRI with a known diagnosis of migraine headache was performed between April 2016 to May 2017.
We included 275 adults (115 men; median age, 38 years, IQR 30-52) with known diagnoses of chronic migraine. Incidental MRI findings were discovered in 157 (57 %) of the scans; 23 (8.3 %) of these were clinically significant, indicating the need for an intervention. Patients aged >40 years were more likely to have an abnormal scan. There were no significant differences related to sex or duration of headaches for more than one year.
The performance of brain MRI warrants consideration in patients who do not respond as expected to migraine and headache treatment. We found clinically significant MRI findings in up to 8 % of such patients. Abnormal imaging findings were the most common among patients of >40 years of age.
偏头痛是神经病学门诊中最常见的主诉之一。偏头痛的准确诊断通常取决于患者的病史，只有在不典型或严重、药物难治性头痛的情况下才进行神经影像学检查，以排除潜在的病变。我们的研究旨在确定慢性头痛的特征性脑磁共振成像（MRI）表现谱。
这是一项回顾性研究，纳入了 2016 年 4 月至 2017 年 5 月期间在沙特阿拉伯吉达的第一扫描放射学诊所因已知偏头痛诊断而接受脑部 MRI 的成年患者。
我们纳入了 275 名（115 名男性；中位数年龄为 38 岁，IQR 为 30-52 岁）已知患有慢性偏头痛的成年人。157 名（57%）扫描发现偶然 MRI 结果；其中 23 名（8.3%）结果具有临床意义，提示需要干预。年龄>40 岁的患者更有可能出现异常扫描。性别或头痛持续时间超过一年与结果之间无显著差异。
对于不符合偏头痛和头痛治疗预期的患者，应考虑进行脑部 MRI。我们发现，多达 8%的此类患者存在有临床意义的 MRI 发现。异常影像学表现最常见于年龄>40 岁的患者。
