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Study: Use of neuroimaging surges in patients with headaches


Neuroimaging for headaches frequently is ordered by physicians during outpatient visits despite guidelines that recommend against such routine procedures, according to a study.

Most headaches are due to benign causes, and multiple guidelines have recommended against routine neuroimaging for headaches, researchers noted in background information for the study, which was published March 17 on the website of JAMA Internal Medicine.

Brian C. Callaghan, MD, MS, of the University of Michigan Health System, Ann Arbor, and colleagues analyzed National Ambulatory Medical Care Survey data for all headache visits for patients 18 and from 2007 through 2010.

There were 51.1 million headache visits during those four years, including 25.4 million for migraines, the researchers reported. Neuroimaging was performed in 12.4% (about 1 in 8) of all headache visits and in 9.8% (about 1 in 10) of migraine visits at an estimated cost of $3.9 billion. The use of neuroimaging increased from 5.1% of all annual headache visits in 1995 to 14.7% in 2010.

“Since 2000, multiple guidelines have recommended against routine neuroimaging in patients with headaches because a serious intracranial pathologic condition is an uncommon cause,” the authors wrote. “Consequently, the magnitude of per-visit neuroimaging use found in this study suggests considerable overuse.”

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