Factors Associated with Incidental Neuroimaging Abnormalities in New Primary Headache PatientsFactors Associated with Incidental Neuroimaging Abnormalities in New Primary Headache Patients
- Authors
- 김병수; 김수경; 김재문; 문희수; 박광열; 박정욱; 손종희; 송태진; 주민경; 차명진; 김병건; 조수진
- Issue Date
- Apr-2020
- Publisher
- 대한신경과학회
- Keywords
- primary headache disorders; headache; neuroimaging; magnetic resonance imaging; logistic models.
- Citation
- Journal of Clinical Neurology, v.16, no.2, pp 222 - 229
- Pages
- 8
- Journal Title
- Journal of Clinical Neurology
- Volume
- 16
- Number
- 2
- Start Page
- 222
- End Page
- 229
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/42257
- DOI
- 10.3988/jcn.2020.16.2.222
- ISSN
- 1738-6586
2005-5013
- Abstract
- Background and Purpose Deciding 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.
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