Pitfalls in Neuroimaging of Headache: A Case Report and Review of the Literature

Headache is a common symptom, with a lifetime prevalence of over 90% of the general population in the United Kingdom (UK). It accounts for 4.4% of consultations in primary care and 30% of neurology outpatient consultations. Neuroimaging is indicated in patients with red flag features for secondary h...

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Main Authors: V. Vallamkondu, M. Shakeel, A. Hussain, D. McAteer
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Otolaryngology
Online Access:http://dx.doi.org/10.1155/2013/735147
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author V. Vallamkondu
M. Shakeel
A. Hussain
D. McAteer
author_facet V. Vallamkondu
M. Shakeel
A. Hussain
D. McAteer
author_sort V. Vallamkondu
collection DOAJ
description Headache is a common symptom, with a lifetime prevalence of over 90% of the general population in the United Kingdom (UK). It accounts for 4.4% of consultations in primary care and 30% of neurology outpatient consultations. Neuroimaging is indicated in patients with red flag features for secondary headaches. The guidelines recommend CT or MRI scan to identify any intracranial pathology. We present a unique case where the initial noncontrast CT scan failed to identify a potential treatable cause for headache. A middle aged man presented with headache and underwent a CT scan without contrast enhancement. The scan was reported as normal. The headache persisted for years and the patient underwent a staging CT scan to investigate an oropharyngeal cancer. This repeat CT scan utilized contrast enhancement and revealed a meningioma. Along with other symptoms, headache is an established presenting complaint in patients with meningioma. The contrast enhanced CT brain proved superior to a nonenhanced CT scan in identifying the meningioma. In a patient with persistent headache where other causes are excluded and a scan is to be requested, perhaps contrast enhanced CT is a better option than a plain CT scan of brain.
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spelling doaj-art-aba1dcf1af8e4f0fa581f2272ad715042025-08-20T02:20:12ZengWileyCase Reports in Otolaryngology2090-67652090-67732013-01-01201310.1155/2013/735147735147Pitfalls in Neuroimaging of Headache: A Case Report and Review of the LiteratureV. Vallamkondu0M. Shakeel1A. Hussain2D. McAteer3Department of Otolaryngology-Head and Neck Surgery, Aberdeen Royal Infirmary, Aberdeen AB252ZN, UKDepartment of Otolaryngology-Head and Neck Surgery, Aberdeen Royal Infirmary, Aberdeen AB252ZN, UKDepartment of Otolaryngology-Head and Neck Surgery, Aberdeen Royal Infirmary, Aberdeen AB252ZN, UKDepartment of Radiology, Aberdeen Royal Infirmary, Aberdeen, UKHeadache is a common symptom, with a lifetime prevalence of over 90% of the general population in the United Kingdom (UK). It accounts for 4.4% of consultations in primary care and 30% of neurology outpatient consultations. Neuroimaging is indicated in patients with red flag features for secondary headaches. The guidelines recommend CT or MRI scan to identify any intracranial pathology. We present a unique case where the initial noncontrast CT scan failed to identify a potential treatable cause for headache. A middle aged man presented with headache and underwent a CT scan without contrast enhancement. The scan was reported as normal. The headache persisted for years and the patient underwent a staging CT scan to investigate an oropharyngeal cancer. This repeat CT scan utilized contrast enhancement and revealed a meningioma. Along with other symptoms, headache is an established presenting complaint in patients with meningioma. The contrast enhanced CT brain proved superior to a nonenhanced CT scan in identifying the meningioma. In a patient with persistent headache where other causes are excluded and a scan is to be requested, perhaps contrast enhanced CT is a better option than a plain CT scan of brain.http://dx.doi.org/10.1155/2013/735147
spellingShingle V. Vallamkondu
M. Shakeel
A. Hussain
D. McAteer
Pitfalls in Neuroimaging of Headache: A Case Report and Review of the Literature
Case Reports in Otolaryngology
title Pitfalls in Neuroimaging of Headache: A Case Report and Review of the Literature
title_full Pitfalls in Neuroimaging of Headache: A Case Report and Review of the Literature
title_fullStr Pitfalls in Neuroimaging of Headache: A Case Report and Review of the Literature
title_full_unstemmed Pitfalls in Neuroimaging of Headache: A Case Report and Review of the Literature
title_short Pitfalls in Neuroimaging of Headache: A Case Report and Review of the Literature
title_sort pitfalls in neuroimaging of headache a case report and review of the literature
url http://dx.doi.org/10.1155/2013/735147
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