Is conventional brain MRI useful for the diagnosis of cluster headache in patients who meet ICHD-3 criteria? Experience in three hospitals in Spain

Pérez-Pereda, Sara; Madera, Jorge; González-Quintanilla, Vicente; Drake-Pérez, Marta; Espí, Clara Naima Marzal; Munuera, C. Serrano; García, Silvia Cusó; Linares, Clara Aguilella; Recio, María Fernández; Delgado, Gabriel Velamazán; Pascual, Julio

doi:10.1016/j.jns.2021.120122

Cited by 4 publications

(3 citation statements)

References 28 publications

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“…The decision to perform neuroimaging in all adult patients with CH, even with typical symptoms, is being discussed. According to some authors, a neuroimaging examination should only be carried out if there are atypical features in the clinical history or neurological examination [ 22 , 26 ]. An onset in childhood, considering the low frequency, should however be addressed as a red flag and demands neuroimaging [ 2 , 3 , 5 ].…”

Section: Diagnosismentioning

confidence: 99%

Cluster Headache: Diagnosis, Management, and Treatment in Pediatric Headache

Borrelli,

Valeriani,

Monte

et al. 2024

JCM

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Despite its rarity, cluster headache can affect children. Patients with cluster headaches often experience symptoms in their adolescence, but the time it takes for a correct diagnosis can be very long. Cluster headache can be mistaken for other pathologies, which can result in patients being diagnosed and treated incorrectly. CH therapy often represents a challenge in pediatric age as there are no studies dedicated to this age category and the therapy strategy is generally based on data from adult experience. The aim of this review is to provide a summary of the current literature on cluster headache in children and adolescents.

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Section: Diagnosismentioning

confidence: 99%

Cluster Headache: Diagnosis, Management, and Treatment in Pediatric Headache

Borrelli,

Valeriani,

Monte

et al. 2024

JCM

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“…As a thorough history generally suffices to diagnose a CH [31], a screening test may seem dispensable. However, surveys indicate a lengthy diagnostic delay in many patients despite the consultation of several physicians [5,6].…”

Section: Summary and Contributionsmentioning

confidence: 99%

Screening for Cluster Headache—Introduction of the SMARTED Scale

Pohl

Joos

Neumeier

et al. 2022

CTN

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Patients with cluster headache often report a long diagnostic delay. This study creates and validates a screening test that could help speed up the diagnostic process. We invited patients to enrol in this diagnostic case–control study if a trigeminal autonomic headache had been suspected or confirmed. Patients in whom the diagnosis of a cluster headache was not made were controls. First, all participants answered 22 diagnostic questions with “yes” or “no”. Next, we eliminated questions that did not distinguish well between the groups. Then, the variables entered a regression model with the headache diagnosis as the dependent variable. Finally, we combined the remaining variables into a diagnostic scale and tested its accuracy. Seventy-four patients participated, 45 of whom suffered from a cluster headache. The analyses identified five questions distinguishing cluster headache patients and controls. These addressed smoking, being awakened by the pain, restlessness during the attack, unilateral tearing, and duration of the attack (hence, the “SMARTED” scale). The area under the ROC curve was 0.938; sensitivity and specificity, the positive and negative predictive values were 98%, 65%, 81% and 94%, respectively. The SMARTED scale validly and accurately screens for cluster headache in patients suspected of a trigeminal autonomic headache.

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“…The latter include different indications to perform neuroimaging examinations depending on the clinical scenario, with a degree of recommendation for each imaging modality (e.g., CT, MRI with or without intravenous contrast). Accordingly, patients with primary headache meeting diagnostic criteria should not undertake brain MRI if neurological examination is normal [ 10 , 11 ] since it does not add clinically-relevant information [ 12 , 13 ]. Nevertheless, in real-world practice, it is common that such a heterogeneous and prevalent condition does not fully meet the exact diagnostic criteria of specific clinical entities, being difficult for clinicians to label a HD as “primary”.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Risk Factors Associated with Tumors and Other Structural Anomalies in Brain MRI Performed to Rule out Secondary Headache: A Multicenter Observational Study

Barbero

Ramos‐Bossini

Rivera-Izquierdo

et al. 2022

IJERPH

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Headache disorders (HDs) are among the most common conditions of the central nervous system, with an estimated prevalence of 50% in adult population. The aim of this work is to analyze the prevalence of structural anomalies that may explain HDs in MRI exams performed to rule out secondary headache in real-world practice, as well as risk factors associated with these lesions. We conducted a retrospective observational study based on a consecutive case series of all patients that underwent brain MRI due to headache from 1 January 2019 to 31 May 2019. We included patients from six MRI diagnostic centers accounting for four provinces of Andalusia (southern Spain). Bivariate and multivariate logistical regression models were performed to identify risk factors associated with the outcomes (1) presence of a structural finding potentially explaining headache, (2) presence of intracranial space-occupying lesions (SOLs), and (3) presence of intracranial tumors (ITs). Of the analyzed sample (1041 patients), a structural finding that could explain headache was found in 224 (21.5%) patients. SOLs were found in 50 (6.8%) patients and ITs in 12 (1.5%) patients. The main factors associated with structural abnormalities were female sex (OR, 1.35; 95% CI, 1.02–1.85), accompanying symptoms (OR, 1.34; 95% CI, 1.05–1.89), use of gadolinium-based contrast agents (OR, 1.89; 95% CI, 1.31–2.72) and previously known conditions potentially explaining headache (OR, 2.44; 95% CI, 1.55–3.84). Female sex (p = 0.048) and accompanying symptoms (p = 0.033) were also associated with ITs in bivariate analyses. Our results may be relevant for different medical specialists involved in the diagnosis, management and prevention of headache. Moreover, the risk factors identified in our study might help the development of public health strategies aimed at early diagnosis of brain tumors. Future studies are warranted to corroborate our findings.

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Is conventional brain MRI useful for the diagnosis of cluster headache in patients who meet ICHD-3 criteria? Experience in three hospitals in Spain

Cited by 4 publications

References 28 publications

Cluster Headache: Diagnosis, Management, and Treatment in Pediatric Headache

Cluster Headache: Diagnosis, Management, and Treatment in Pediatric Headache

Screening for Cluster Headache—Introduction of the SMARTED Scale

Prevalence and Risk Factors Associated with Tumors and Other Structural Anomalies in Brain MRI Performed to Rule out Secondary Headache: A Multicenter Observational Study

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