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Brain magnetic resonance imaging findings in children with headache
Esra Gurkas1, Zeynep S Karalok2, Birce D Taskın2
1Department of Pediatric Neurology, Ankara Pediatric and Pediatric Hematology Oncology Training and Research Hospital, Ankara, Turkey. esragurkas@yahoo.com.
Insights
Brain MRI in children with headache rarely reveals significant findings. Most magnetic resonance imaging (MRI) scans showed nonspecific abnormalities, with few directly linked to the headache cause.
Area of Science:
- Pediatric Neurology
- Neuroradiology
Background:
- Headache is a common complaint in pediatric neurology outpatient clinics.
- Magnetic resonance imaging (MRI) is frequently utilized to investigate headaches in children.
Purpose of the Study:
- To describe the findings of brain MRI in pediatric patients presenting with headache.
- To evaluate the diagnostic yield of MRI for headaches in children.
Main Methods:
- Retrospective review of medical records for patients aged under 18 with headache complaints.
- Data collected from January 2013 to December 2014 in pediatric neurology clinics.
- Analysis of brain MRI findings in relation to headache diagnosis.
Main Results:
- 478 children with headache were analyzed; 85% underwent brain MRI.
- Cerebral abnormalities were found in 31.4% of MRIs, but only 5 cases were directly relevant to the headache (e.g., tumors).
- Common nonspecific findings included white matter abnormalities (10%), enlarged perivascular spaces (4%), and arachnoid cysts (4%). Extra-cerebral findings like sinusitis were noted in 4.1%.
Conclusions:
- Brain MRI has a low contribution to the diagnosis and management of headaches in the majority of pediatric patients.
- Most MRI findings in children with headache are nonspecific or incidental.
- Further research may refine indications for MRI in pediatric headache evaluation.
Introduction:
The aim was to describe the findings on magnetic resonance imaging (MRI) in children with headache.
Population And Methods:
Retrospective review of the medical records of patients who were admitted to our pediatric outpatient neurology clinics with the complaint of headache between January 2013 and December 2014.
Results:
A total of 478 patients (273 female, 205 male) were admitted with the complaint of headache. The types of headache were migraine in 218 (45.6%), tension-type in 159 (33.3%), secondary in 39 (8.2%) and unspecified headaches in 62 (13%) patients. Brain MRI was performed in 407 (85%) patients and revealed cerebral abnormalities in 128 (31.4%) patients; 5 patients had cerebral abnormalities relevant with headache, including tumors. Amongst the others 123 patients, the most common findings were 42 cases (10%) of nonspecific white matter abnormalities, 17 cases (4%) of enlarged perivascular spaces, 17 cases (4%) of arachnoid cyst, 16 cases (3.9%) of asymmetric ventricles, 12 cases (2.9%) with Chiari type I and cerebellar tonsillar ectopia. Also, 17 (4.1%) patients had extra-cerebral MRI abnormalities including sinusitis, mucosal thickening and retention cysts of sinuses.
Conclusions:
In this study, the contribution of brain MRI in the diagnosis and management of the children with headache was still low.
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