AUDIT OF APPROPRIATENESS AND OUTCOME OF COMPUTED TOMOGRAPHY BRAIN SCANNING FOR HEADACHES IN PAEDIATRIC AGE GROUP
Abstract
Background: Headache is a common complaint in children. With the proliferation of brain imagingcenters and the increasing patient demand for CT or MRI studies, brain imaging has become widely usedto evaluate headache and exclude malignant lesion. The objectives of this descriptive study were to assessthe appropriateness and outcomes of computed tomography brain scanning for headaches in paediatric agegroup. This study was conducted at the Radiology Department Hayatabad Medical Complex, Peshawarover a period of 1 year July 2008–July 2009. Methods: Both genders between the ages of 4–18 yearsincluded in the study presenting with headache either isolated or common/classic migraine were includedin this study. These variants of headache were allocated an appropriateness rating of 2 for CT scan by theAmerican College of Radiology Appropriateness Criteria (ACRAC) for children with headaches. Results:Out of the 100 patients only 4% patients showed abnormal findings on CT scan while the remaining 96%of the scans were absolutely normal. The four patients with abnormal findings all had sinusitis nonotorious lesions. Conclusion: This audit suggests that a proportion of the computed tomography studiesperformed for children with isolated headaches or common/classic migraine may have been inappropriate.The development of a local guideline for imaging referral is indicated.Keywords: Children, Headache, Computed tomographyReferences
Maytal J, Bienkowski RS, Patel M, Eviatar L. The value of
brain imaging in children with headaches. Pediatrics
;96:413–6.
Abu-Arafeh I, Russell G. Prevalence and causes of headache
in schoolchildren. BMJ 1994;309:765–9.
Haslam RA. Headaches. In Behrman RE, Kliegman RM,
Jenson HB, eds. Nelson textbook of pediatrics 16th ed.
Philadelphia: WB Saunders; 2000. p.1834.
Kan EYL, Wong IYC, Lau SPC. Audit of Appropriateness
and Outcome of Computed Tomography Brain Scanning for
Headaches in Paediatric Patients. J HK Coll Radiol
;8:202–6.
American College of Radiology. ACR Appropriateness
Criteria. Headache-child. Available from: http://www.acr.org/
s_acr/bin.asp?CID=1204&DID=FILE.PDF
Alehan FK. Value of neuroimaging in the evaluation of
neurologically normal children with recurrent headache. J
Child Neurol 2002;17:807–9.
Sillanpaa M. Headache in children. In: Olesen J, editor.
Headache classification and epidemiology. New York, NY:
Raven Press; 1994.p.273–81.
J Ayub Med Coll Abbottabad 2009;21(1)
http://www.ayubmed.edu.pk/JAMC/PAST/21-1/Nawaz.pdf 93
Siddiqui SJ, Shamim SMS, Hashimi AM. Prevalence and
patterns of headache in school children in Karachi. J Pak
Med Assoc 2006;56:215–7.
Linet MS, Stewart WF, Celentano DD, Ziegler D, Sprecher
M. An epidemiologic study of headache among adolescents
and young adults. JAMA 1989;261:2211–6.
Medina LS, Amaral JGPV. Imaging in the paediatric patients
with headache. Int Paed 2002;17:76–83.
Griffiths PD. Computed tomography in headache in children.
BMJ 2004;329:930–2.
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