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wysper
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Quick question
« on: Sep 9th, 2006, 11:31am » |
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Can a CT scan or a MRI show anything if you're not in the middle of an attack?
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E-Double
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Re: Quick question
« Reply #1 on: Sep 9th, 2006, 12:04pm » |
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Nope......although they are finding differences in hypothalmus between CHer's and non CHers using PET scan
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| « Last Edit: Sep 9th, 2006, 12:05pm by E-Double » |
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I can't believe that I have to bang my
Head against this wall again
But the blows they have just a little more
Space in-between them
Gonna take a breath and try again.
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The mad viking
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Re: Quick question
« Reply #2 on: Sep 9th, 2006, 12:06pm » |
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As far as i know the only thing that might show an attack or reaction of an attack the brain is a petscan.
At least some of the gurues says that
Svenn
Would have tried it myself IF there was a way for me to lay quiet"dead"the time it takes in the pet-machine.So far not a chanse for that
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| « Last Edit: Sep 9th, 2006, 12:08pm by The mad viking » |
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Bob_Johnson
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Re: Quick question
« Reply #3 on: Sep 10th, 2006, 2:45pm » |
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To scan or not to scan in headache
Some patients with primary headaches may need imaging
Some life threatening brain disorders present with secondary headache, where the headache is caused by the disease. A brain tumour, for example, is best diagnosed by brain imaging early in the course of the disease, which is essential for optimal management of this and other secondary headache disorders. However, brain tumours, as an example, account for less than 0.1% of the lifetime prevalence of headache.1 This contrasts with the fact that most headaches in the community are either associated with mild systemic infection or due to primary headache,1 where the headache is itself the disorder. Dissecting primary from secondary headache is the problem, since, by definition, primary headache does not need brain imaging because no disease process exists that leads to macroscopic change in general terms.
How does one dissect primary from secondary headache? This question can have only a clinical response since no controlled trials have been conducted to identify causes of secondary headache. In clinical practice we generally accept that the so called red flags of headache should trigger a search for secondary headache.2 Thus change in the pattern of headache; new onset of headache in people older than 50; onset of seizures or headache associated with systemic illness, including fever; personality change; or with symptoms suggestive of raised intracranial pressure, such as new onset headache in the early morning; or headache that is worsening with coughing, sneezing, or straining should each be viewed with concern. Acute onset of the worst headache of the patient's life should trigger immediate referral for consideration as a sentinel headache of an intracranial aneurysm. An abnormal neurological finding is a clear indication to investigate, unless the finding is longstanding.2 Fortunately most worsening of headache is probably longstanding primary headache going into a more troublesome period, which mercifully is not a marker of a life threatening problem.
BMJ 28 Aug 2004[Not complete article here.]
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Imaging Strategies
For the vast majority of patients presenting with a headache, no imaging studies are necessary. It is estimated that only 1 in 250,000 headaches are secondary to a life-threatening condition compared with the 1 in 11 Americans who suffer from migraines.[3] The US Headache Consortium has recently offered guidelines for imaging.[4] Patients with an abnormal neurologic examination should be considered for imaging along with those presenting with an atypical headache. Magnetic resonance imaging (MRI) and computed tomography (CT) are the usual accepted methods of imaging. The Consortium has no evidence-based recommendation regarding the "relative sensitivity of MRI as compared with CT in the evaluation of migraine or other nonacute headache."[4] However, MRI is often preferred to look for suspected underlying structural abnormalities, such as tumors, while CT tends to be preferred for diagnosing subarachnoid hemorrhage.
Dr. Unger discussed headaches at the 2003 AAFP Scientific assembly and presented the following "comfort" and "danger" signs as guides for imaging or other additional testing.[5] Comfort signs that are less likely to be associated with a secondary or life-threatening headache include positive family history of migraine, headaches that are menstrually related, those preceded by typical aura, or those that are periodic and stable over time. The clinician should consider additional testing in the presence of any "headache danger signs:" "the worst headache of my life"; sudden onset of a severe "thunderclap" headache; new onset in a patient older than 50 years of age; fever, confusion, or neck stiffness; loss of consciousness or any focal neurologic finding; or any change in headache pattern, such as progressive headaches without any symptom-free intervals. Dr. Darlow also added that the need for reassurance, either for the patient or clinician, is a possible reason to screen.[6]
MEDSCAPE
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Bob Johnson
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