Non-traumatic headache as an emergent conditions-role of MRI
A review article
Keywords:
Non-traumatic headache, MRI, emergency department, neuroimaging, secondary headache, predictive modelAbstract
Background: Non-traumatic headaches are a prevalent neurological issue in emergency departments, affecting about 1–4% of patients. These headaches can be classified as primary or secondary, with the latter posing a risk of severe complications. Neuroimaging is critical for identifying secondary headache causes, with CT traditionally used to reveal abnormalities in 13–15% of patients. MRI offers superior soft tissue imaging without ionizing radiation, yet its use in emergency settings remains under-explored. Risk scoring systems have been developed to guide imaging decisions, focusing on patient age, neurological deficits, and other symptoms as predictors of intracranial pathology. Aim: This review aims to evaluate the role of MRI in diagnosing non-traumatic headaches in emergency settings and to analyze clinical guidelines for its appropriate use. Methods: A retrospective investigation was conducted on emergency patients presenting with non-traumatic headaches, analyzing MRI findings, demographics, and clinical presentations. Results: MRI identified significant abnormalities in approximately 20% of patients. Factors such as age, smoking status, and signs of infection correlated with abnormal findings, while a history of migraine appeared protective. The predictive model for identifying significant imaging outcomes showed limited clinical utility. Conclusion: MRI is a valuable tool in assessing non-traumatic headaches in emergency departments, particularly in high-risk patients.
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