Clinical predictors of significant intracranial computed tomography scan findings in adults experiencing headache disorder

Kengne, Ulrich Igor Mbessoh; Tegueu, Callixte Kuate; Mankong, Dorothée Soh; Mbede, Maggy; Tene, Ulrich Gaël; Moifo, Boniface

doi:10.11604/pamj.2020.35.81.16041

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…Similarly, in a study done in Cameroon, Central Africa, abnormal results in the neurological examination were found to be the best clinical predictors of structural intracranial pathology in head CT in an adult patient experiencing headache disorder. 20 It was concluded that routine computed tomography of the brain in headache patients with normal physical and neurologic exams and no unusual clinical symptoms has a low likelihood ratio for discovering significant intracranial disease.…”

Section: Discussionmentioning

confidence: 99%

Head computed tomography findings in relation to red flag signs among patients presenting with non-traumatic headache in the emergency services

Gajurel¹,

Shakya

Neupane

et al. 2021

J Patan Acad Health Sci

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Introduction: Non-traumatic headaches are a common presentation in emergency services. A non-contrast computed tomography (NCCT) scan of the head is done when there is suspicion of intracranial abnormalities. Such intracranial abnormalities are indicated by "red flag" signs. This study aimed to determine the prevalence of intracranial abnormalities in patients with non-traumatic headaches and its association with the red flag signs. Method: A total of 106 patients presenting with a non-traumatic headache to the emergency services of TUTH from Aug 2019 to Aug 2020, who underwent head CT were included in the study. The association of head CT positivity with the presence of red flag signs was studied by bivariate analysis using the chi-square test or Fisher exact test. Result: Among 106 patients, 46(43.4%) were male and the rest were female. The mean age of the patient was 43.69+17.46. All the patients who had positive findings in head CT had at least one red flag sign. Out of 16 red flag signs included in this study, 10 signs showed a significant association (p<0.05) with head CT positivity. These are sudden onset of headache, age of onset >50 years, significant change in pattern or severity of headache, “worst headache ever”, vomiting, neck stiffness, seizures, altered sensorium, papilledema, and focal neurological deficits. Conclusion: Red flag signs of headache are helpful to determine whether head CT is needed or not to look for significant intracranial abnormalities in a patient presenting with non-traumatic headache in an emergency.

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Section: Discussionmentioning

confidence: 99%

Head computed tomography findings in relation to red flag signs among patients presenting with non-traumatic headache in the emergency services

Gajurel¹,

Shakya

Neupane

et al. 2021

J Patan Acad Health Sci

View full text Add to dashboard Cite

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“…However, for some complaints, such as headaches, there is a need for accessible and objective parameters that can be used in addition to vital signs. Headache is among the most important complaints, accounting for 0.5-4.5% of all ED visits ( 3 ). Most headache cases present to the ED with primary headaches, and approximately half are diagnosed with migraine or other headache types ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Is near-infrared spectroscopy a promising predictor for early intracranial hemorrhage diagnosis in the Emergency Department?

Çınaroğlu,

Bora,

Acar

et al. 2024

Braz J Med Biol Res

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Intracranial hemorrhage (ICH) is a serious medical condition that can lead to significant morbidity and mortality if not diagnosed and treated promptly. Early detection and treatment are essential for improving the outcome in patients with ICH. Near-infrared spectroscopy (NIRS) is a non-invasive imaging technique that has been used to detect changes in brain tissue oxygenation and blood flow in various conditions. The aim of this study was to investigate the predictive potential of NIRS for early diagnosis of ICH in patients presenting to the Emergency Department (ED) triage with headache. A total of 378 patients were included in the study. According to the final diagnosis of the patients, 4 groups were formed: migraine, tension-cluster headache, intracranial hemorrhage and intracranial mass, and control group. Cerebral NIRS values “rSO 2 ” were measured at the first professional medical contact with the patient. The right and left rSO 2 (RrSO 2 , LrSO 2 ) were significantly lower and the rSO 2 difference was significantly higher in the intracranial hemorrhage group compared to all other patient groups (P<0.001). The cut-off values determined in the receiver operating characteristics (ROC) analysis were RrSO 2 ≤67, LrSO 2 ≤67, and ΔrSO 2 ≥9. This study found that a difference of more than 9 in cerebral right-left NIRS values can be a non-invasive, easy-to-administer, rapid, and reliable diagnostic test for early detection of intracranial bleeding. NIRS holds promise as an objective method in ED triage for patients with intracranial hemorrhage. However, further research is needed to fully understand the potential benefits and limitations of this method.

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“…Headache accounts for between 1-3% of admissions to emergency departments (ED), and migraine diagnosis at discharge from ED is variable, ranging from 15-32% [1]; and the most important issue in ED, is rule-out a secondary headache; and to achieve this goal, a detailed headache anamnesis is mandatory complemented whit a methodical neurological examination in search or the "Red flags" that include sudden onset of headache, onset age after 50 years, increased frequency or severity of headache, new onset of headache in patients with underlying medical condition, or headache with concomitant systemic illness, focal neurologic sings or symptoms, papilledema and post head trauma headache [2]. From all this "Red flags", according some authors, abnormal results from neurological examination are considerate the best clinical parameters to predict a structural intracranial pathology on CT-scan [3].…”

Section: Introductionmentioning

confidence: 99%

Benign Episodic Unilateral Mydriasis: Normal Phenomenon in Migraine? Considerations from A Clinical Case

Cañas¹

2021

ANN

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Clinical predictors of significant intracranial computed tomography scan findings in adults experiencing headache disorder

Cited by 3 publications

References 19 publications

Head computed tomography findings in relation to red flag signs among patients presenting with non-traumatic headache in the emergency services

Head computed tomography findings in relation to red flag signs among patients presenting with non-traumatic headache in the emergency services

Is near-infrared spectroscopy a promising predictor for early intracranial hemorrhage diagnosis in the Emergency Department?

Benign Episodic Unilateral Mydriasis: Normal Phenomenon in Migraine? Considerations from A Clinical Case

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