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DTI of the Visual Pathway - White Matter Tracts and Cerebral Lesions
10:05

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Published on: August 26, 2014

Incidental white matter lesions in children presentıng with headache

Erhan Bayram1, Yasemin Topcu, Pakize Karaoglu

  • 1Department of Pediatrics, Division of Pediatric Neurology, Dokuz Eylul University Hospital, Izmir, Turkey. dr.erhanbayram@yahoo.com

Headache
|April 5, 2013
PubMed

Insights

White matter lesions on MRI are incidentally found in some children with headaches. These non-specific changes in children with normal development do not typically worsen over time.

Area of Science:

  • Pediatric Neurology
  • Neuroradiology

Background:

  • Headaches are a common presenting complaint in pediatric neurology.
  • Magnetic resonance imaging (MRI) is frequently used to evaluate headaches in children.
  • White matter lesions (WMLs) on MRI can be incidental findings.

Purpose of the Study:

  • To determine the prevalence and clinical significance of white matter lesions (WMLs) detected by MRI in children presenting with headaches.
  • To assess the natural history of incidental WMLs in this pediatric population.

Main Methods:

  • Retrospective review of clinical and neuroimaging data for 941 children with headaches who underwent neuroimaging between 2007 and 2012.
  • Detailed documentation of MRI findings, with specific attention to WMLs.
  • Follow-up assessment of patients with non-specific WMLs to evaluate headache status and neurological findings.

Main Results:

  • Of 941 children, 22.1% had abnormal cranial MRI findings. Incidental non-specific WMLs were found in 4.4% (23/527) of patients.
  • Patients with WMLs had normal psychomotor development, no history of seizures or head trauma, and normal neurological examinations.
  • During a mean follow-up of 16.8 months, no neurological deterioration or new WMLs were observed. Lesions were supratentorial, with a mean size of 5.1 mm.

Conclusions:

  • Incidental non-specific white matter changes can be observed in children with headaches.
  • Repeated imaging studies are generally not warranted for these findings if the clinical course is normal.
  • Imaging follow-up should be individualized based on the patient's clinical progression.
Abstract

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