Sign Up for a Free Account
  • Updated 07.06.2024
  • Released 12.11.2000
  • Expires For CME 07.06.2027

Neuroimaging of headache

Introduction

Overview

Although usually benign, headache can herald serious intracranial disease. Neuroimaging must be considered whenever secondary causes of headache are suspected. This review focuses on indications for neuroimaging in clinical practice and the contribution that neuroimaging has made to our understanding of headache pathophysiology. Advances in imaging, such as functional MRI to study migraine pathophysiology, now demonstrate the role of the hypothalamus, brainstem structure, and network abnormalities. This review also highlights serious secondary causes of headache such as vascular disorders and tumors as a trigger for headache and, occasionally, cluster headache as well as neuroimaging findings in patients headache related to COVID-19.

Key points

• Most patients with headache do not need neuroimaging.

• Use “red flags” based on history and exam findings to determine the necessity of neuroimaging.”

• Although neuroimaging is usually normal in patients with migraine, unusual primary headaches such as trigeminal autonomic cephalalgias or cough headache may be an exception.

Historical note and terminology

Headache diagnosis is clinical, based on a careful history and physical exam (51). The International Headache Society Classification defines headaches as primary, based on their clinical features or genetic markers, or secondary due to another proven cause (43). For primary headache disorders such as migraine, diagnosis does not rely on neuroimaging.

This is an article preview.
Start a Free Account
to access the full version.

  • Nearly 3,000 illustrations, including video clips of neurologic disorders.

  • Every article is reviewed by our esteemed Editorial Board for accuracy and currency.

  • Full spectrum of neurology in 1,200 comprehensive articles.

  • Listen to MedLink on the go with Audio versions of each article.

Questions or Comment?

MedLink®, LLC

3525 Del Mar Heights Rd, Ste 304
San Diego, CA 92130-2122

Toll Free (U.S. + Canada): 800-452-2400

US Number: +1-619-640-4660

Support: service@medlink.com

Editor: editor@medlink.com

ISSN: 2831-9125