n South African Medical Journal - Neuroimaging in migraine : correspondence




: In a recent paper published in , the official journal of the American Headache Society, Callaghan reported on information extracted from more than 50 million headache visits in the USA. This indicated that as many as 9.8% of patients with a diagnosis of migraines underwent neuroimaging - either magnetic resonance angiography or computed tomography. After removing those patients with 'red flags' on neurological evaluation, the percentage undergoing neuroimaging decreased from 9.8% to 8.3%. This was contrary to the guidelines originally laid down by Frishberg, and later confirmed in a number of studies. These guidelines suggested that for migraines, there was no difference in the incidence of clinically meaningful pathology to the incidence in the general population, and that neuroimaging is unnecessary.


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