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Factors Associated with Incidental Neuroimaging Abnormalities in New Primary Headache Patients

Authors
 Byung Su Kim  ;  Soo Kyoung Kim  ;  Jae Moon Kim  ;  Heui Soo Moon  ;  Kwang Yeol Park  ;  Jeong Wook Park  ;  Jong Hee Sohn  ;  Tae Jin Song  ;  Min Kyung Chu  ;  Myoung Jin Cha  ;  Byung Kun Kim  ;  Soo Jin Cho 
Citation
 JOURNAL OF CLINICAL NEUROLOGY, Vol.16(2) : 222-229, 2020-04 
Journal Title
 JOURNAL OF CLINICAL NEUROLOGY 
ISSN
 1738-6586 
Issue Date
2020-04
Keywords
headache ; logistic models ; magnetic resonance imaging ; neuroimaging ; primary headache disorders
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.
Files in This Item:
T202005941.pdf Download
DOI
10.3988/jcn.2020.16.2.222
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Chu, Min Kyung(주민경) ORCID logo https://orcid.org/0000-0001-6221-1346
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/181483
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