The Effectiveness of Brain MRI in Children and Adolescents with Headache

Park, Sang Wook; Park, Hyun A; Kim, Dong Wook

Abstract

PURPOSE
In this study, the authors classified the pediatric headache patients according to the presence of associated symptoms or signs, and the duration of headache. The purpose of this study is to evaluate the clinical usefulness of brain MRI in pediatric headache.
METHODS
Total 1859 patients diagnosed with headache, migraine, other headache syndromes were recruited in the patients at the age of 4-14 years who visited Inje University Ilsan Paik Hospital between 2012 and 2016. 216 patients who met the exclusion criteria were excluded. Of total 1643 patients, 304 patients had brain MRI, and the brain MRI results were retrospectively analyzed.
RESULTS
The mean age of 304 patients who had brain MRI was 9.4 years. Among the 316 brain MRI results of total 304 patients, the most common finding was normal in 58.5%, followed by incidental findings (23.4%) and pathologic findings (18.0%). The patients group with associated symptoms or signs with headache showed less normal findings, more incidental and pathologic findings than those without associated symptoms or signs. The MRI findings of two groups showed significant difference (P=0.049). The patients group with less than 3 months of headache showed less normal findings, more incidental and pathologic findings than those with more than 3 months of headache. The MRI findings of the two groups showed significant difference (P=0.001).
CONCLUSIONS
Brain MRI should be performed with careful history taking and neurologic evaluation to rule out the underlying intracranial diseases especially in case of headaches with associated symptoms or signs.