What is the role of neuroimaging in the workup of pediatric headache?

Updated: Jan 02, 2019
  • Author: J Ivan Lopez, MD, FAAN, FAHS; Chief Editor: George I Jallo, MD  more...
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Answer

Neuroimaging (eg, computed tomography [CT] scanning, MRI) usually is not indicated for the routine care of patients with headache except possibly in the very young child and if absolutely no family history can be found despite thorough review. However, according to a study of over 700 children by Graf et al, there appears to be an increase in the rate at which neuroimaging for nonacute headache is being ordered by primary care physicians. [42]

If the baseline neurologic examination changes, neuroimaging should be considered. Neuroimaging is also warranted, despite normal baseline examination findings, if a patient’s first seizure is coincident with a headache, to exclude the possibility of an intracranial mass.


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