Migraine CT: Difference between revisions
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==Overview== | ==Overview== | ||
Head images such [[CT]] and [[MRI]] are needed to rule out other possible causes of [[headache]]. | Head images such [[CT]] and [[MRI]] are needed to rule out other possible causes of [[headache]]. [[Neuroimaging]] is not necessary in all patients with migraine. | ||
===CT And MRI== | |||
[[CT]] and [[MRI]] are indicated in patients with: <ref> name="pmid10993991">{{cite journal| author=Silberstein SD| title=Practice parameter: evidence-based guidelines for migraine headache (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. | journal=Neurology | year= 2000 | volume= 55 | issue= 6 | pages= 754-62 | pmid=10993991 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10993991 }} </ref> <ref name="pmid24400971">{{cite journal| author=Lanteri-Minet M, Valade D, Geraud G, Lucas C, Donnet A| title=Revised French guidelines for the diagnosis and management of migraine in adults and children. | journal=J Headache Pain | year= 2014 | volume= 15 | issue= 1 | pages= 2 | pmid=24400971 | doi=10.1186/1129-2377-15-2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24400971 }} </ref> | |||
* Abnormal [[Physical examination|clinical examinations]] | |||
* Atypical [[aura]]: sudden onset, lasting more than 1 hour, always at the same side and/or without [[visual]] symptoms | |||
* Migraine attacks that begin after 50 years of age | |||
[[CT]] and [[MRI]] are not indicated in: | |||
* Patients with a diagnosis of migraine in accordance with the [[International Headache Society| IHS]] [[Migraine criteria|criteria for migraine]]. | |||
* Differentiating a migraine from other [[Headache classification|primary headaches]] | |||
Symptoms that may indicate an abnormality on [[neuroimaging]]:<ref> name="pmid8800932">{{cite journal| author=Russell MB, Olesen J| title=A nosographic analysis of the migraine aura in a general population. | journal=Brain | year= 1996 | volume= 119 ( Pt 2) | issue= | pages= 355-61 | pmid=8800932 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8800932 }} </ref><ref> name="pmid7877390">{{cite journal| author=Kumar KL, Cooney TG| title=Headaches. | journal=Med Clin North Am | year= 1995 | volume= 79 | issue= 2 | pages= 261-86 | pmid=7877390 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7877390 }} </ref> | |||
* Increase of [[headache]]'s frequency | |||
* Poor [[coordination]] | |||
* [[Focal neurologic signs]] | |||
* If [[headache]]'s are awakening the patient. | |||
In migraineus patients with an unusual [[headache]], its suggested that a [[CT scan]] is made without [[Radiocontrast|contrast]]. | |||
[[MRI]] is indicated when there is suspicion of [[Posterior cranial fossa|posterior fossa]] lesions and [[cerebrospinal fluid]] (CSF) leak. [[Magnetic resonance angiography]] (MRA) and [[Magnetic resonance angiography|magnetic resonance venography]] (MRV) are indicated in arterial or venous lesions. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 20:37, 4 February 2014
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Overview
Head images such CT and MRI are needed to rule out other possible causes of headache. Neuroimaging is not necessary in all patients with migraine.
=CT And MRI
CT and MRI are indicated in patients with: [1] [2]
- Abnormal clinical examinations
- Atypical aura: sudden onset, lasting more than 1 hour, always at the same side and/or without visual symptoms
- Migraine attacks that begin after 50 years of age
CT and MRI are not indicated in:
- Patients with a diagnosis of migraine in accordance with the IHS criteria for migraine.
- Differentiating a migraine from other primary headaches
Symptoms that may indicate an abnormality on neuroimaging:[3][4]
- Increase of headache's frequency
- Poor coordination
- Focal neurologic signs
- If headache's are awakening the patient.
In migraineus patients with an unusual headache, its suggested that a CT scan is made without contrast. MRI is indicated when there is suspicion of posterior fossa lesions and cerebrospinal fluid (CSF) leak. Magnetic resonance angiography (MRA) and magnetic resonance venography (MRV) are indicated in arterial or venous lesions.
References
- ↑ name="pmid10993991">Silberstein SD (2000). "Practice parameter: evidence-based guidelines for migraine headache (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology". Neurology. 55 (6): 754–62. PMID 10993991.
- ↑ Lanteri-Minet M, Valade D, Geraud G, Lucas C, Donnet A (2014). "Revised French guidelines for the diagnosis and management of migraine in adults and children". J Headache Pain. 15 (1): 2. doi:10.1186/1129-2377-15-2. PMID 24400971.
- ↑ name="pmid8800932">Russell MB, Olesen J (1996). "A nosographic analysis of the migraine aura in a general population". Brain. 119 ( Pt 2): 355–61. PMID 8800932.
- ↑ name="pmid7877390">Kumar KL, Cooney TG (1995). "Headaches". Med Clin North Am. 79 (2): 261–86. PMID 7877390.