Mohammed H Alanazy, Hassan Almalak, Malak Alaboudi, Abdullah Abujamea, Abdul Albilali, Taim Muayqil
{"title":"Common diagnoses and factors associated with abnormal neuroimaging in headache patients in the emergency department.","authors":"Mohammed H Alanazy, Hassan Almalak, Malak Alaboudi, Abdullah Abujamea, Abdul Albilali, Taim Muayqil","doi":"10.17712/nsj.2023.1.20220042","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To determine causes of headaches in patients who presented to the emergency department (ED) and underwent neuroimaging, and to determine the clinical features associated with abnormal neuroimaging.</p><p><strong>Methods: </strong>Patients were retrospectively selected from a database between June, 2015 and May, 2019. Patients were included if they had neuroimaging requested from the ED mainly for headache. Associations between clinical characteristics and abnormal neuroimaging were assessed.</p><p><strong>Results: </strong>We included 329 patients (33.4% men, 66.6% women). The mean (SD) age was 39.7 (18.4) years. Neurological signs were reported in 43.8% of the patients, head-computed tomography was requested in 79.6%, magnetic resonance imaging in 77.5%, and both in 57.1%. Abnormal neuroimaging was reported in 31.9%. The most common reported diagnoses were secondary headache disorders (48.9%), followed by primary headache disorders (16.4%). The remainder were nonspecific-headaches (35%). Variables associated with abnormal neuroimaging were headache onset ≤1 month (OR 3.37, CI 1.47-7.70, <i>p</i>=0.004), and presence of an abnormal neurological sign (OR 3.60, CI 1.89-6.83, <i>p</i><0.001).</p><p><strong>Conclusion: </strong>Secondary headache disorders are common in patients who undergo neuroimaging in the ED. Those who have a neurological sign and recent onset of headache are more likely to have abnormal neuroimaging.</p>","PeriodicalId":19284,"journal":{"name":"Neurosciences","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7b/7e/Neurosciences-28-1-36.PMC9987621.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurosciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.17712/nsj.2023.1.20220042","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: To determine causes of headaches in patients who presented to the emergency department (ED) and underwent neuroimaging, and to determine the clinical features associated with abnormal neuroimaging.
Methods: Patients were retrospectively selected from a database between June, 2015 and May, 2019. Patients were included if they had neuroimaging requested from the ED mainly for headache. Associations between clinical characteristics and abnormal neuroimaging were assessed.
Results: We included 329 patients (33.4% men, 66.6% women). The mean (SD) age was 39.7 (18.4) years. Neurological signs were reported in 43.8% of the patients, head-computed tomography was requested in 79.6%, magnetic resonance imaging in 77.5%, and both in 57.1%. Abnormal neuroimaging was reported in 31.9%. The most common reported diagnoses were secondary headache disorders (48.9%), followed by primary headache disorders (16.4%). The remainder were nonspecific-headaches (35%). Variables associated with abnormal neuroimaging were headache onset ≤1 month (OR 3.37, CI 1.47-7.70, p=0.004), and presence of an abnormal neurological sign (OR 3.60, CI 1.89-6.83, p<0.001).
Conclusion: Secondary headache disorders are common in patients who undergo neuroimaging in the ED. Those who have a neurological sign and recent onset of headache are more likely to have abnormal neuroimaging.
目的:确定急诊科(ED)接受神经影像学检查的患者头痛的原因,并确定与异常神经影像学检查相关的临床特征。方法:从2015年6月至2019年5月的数据库中回顾性选择患者。如果患者主要因头痛而要求急诊科进行神经影像学检查,则纳入其中。评估临床特征与异常神经影像学之间的关系。结果:纳入329例患者(男性33.4%,女性66.6%)。平均(SD)年龄为39.7(18.4)岁。43.8%的患者报告了神经系统症状,79.6%的患者要求进行头部计算机断层扫描,77.5%的患者要求进行磁共振成像,57.1%的患者要求进行这两项检查。神经影像学异常占31.9%。最常见的诊断报告是继发性头痛疾病(48.9%),其次是原发性头痛疾病(16.4%)。其余为非特异性头痛(35%)。与异常神经影像学相关的变量为头痛发作≤1个月(OR 3.37, CI 1.47-7.70, p=0.004),以及是否存在异常神经体征(OR 3.60, CI 1.89-6.83, p)。结论:继发性头痛疾病在急诊科接受神经影像学检查的患者中很常见。有神经体征且近期出现头痛的患者更容易出现异常神经影像学检查。
期刊介绍:
Neurosciences is an open access, peer-reviewed, quarterly publication. Authors are invited to submit for publication articles reporting original work related to the nervous system, e.g., neurology, neurophysiology, neuroradiology, neurosurgery, neurorehabilitation, neurooncology, neuropsychiatry, and neurogenetics, etc. Basic research withclear clinical implications will also be considered. Review articles of current interest and high standard are welcomed for consideration. Prospective workshould not be backdated. There are also sections for Case Reports, Brief Communication, Correspondence, and medical news items. To promote continuous education, training, and learning, we include Clinical Images and MCQ’s. Highlights of international and regional meetings of interest, and specialized supplements will also be considered. All submissions must conform to the Uniform Requirements.