Professional paper

The Use of Neuroimaging in the Management of Chronic Headache in Children in Clinical Practice Versus Clinical Practice Guidelines

Igor Prpić ; Clinical Department of Pediatrics, Rijeka University Hospital Center, School of Medicine, University of Rijeka, Croatia
Tea Ahel ; Emergency Medicine Institute of Primorje-Gorski Kotar County, Rijeka, Croatia
Krešimir Rotim ; Clinical Department of Neurosurgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Domagoj Gajski ; Department of Anatomy and Physiology, University of Applied Health Sciences, Zagreb, Croatia
Petar Vukelić ; Clinical Department of Pediatrics, Rijeka University Hospital Center, School of Medicine, University of Rijeka, Croatia
Antun Sasso ; Clinical Department of Pediatrics, Rijeka University Hospital Center, School of Medicine, University of Rijeka, Croatia

Abstract

In daily practice, neuroimaging studies are frequently performed for the management of childhood headache. The aim of this study was to determine whether there is significant discrepancy between clinical practice and clinical practice guidelines on the indications for neuroimaging studies. Medical records of children with chronic headache, aged 2 to 18 years and treated at Rijeka University Hospital Center, Kantrida Department of Pediatrics, were retrospectively reviewed. Indications for brain magnetic resonance imaging and computed tomography (MRI/CT) scanning were reviewed and compared with clinical practice guidelines. Brain imaging was performed in 164 (76.3%) of 215 children, MRI in 93 (56.7%) and CT in 71 (43.3%) children. Indications for brain MRI/CT were as follows: anxiety and/or insistence by the child’s family (71.3%), presence of associated features suggesting neurologic dysfunction (13.4%), age under 5 years (12.8%) and abnormal neurologic examination (2.4%). The majority of children (71.4%) had normal neuroimaging findings. In the rest of imaging studies (28.1%), MRI/CT revealed different intracerebral/extracerebral findings not influencing changes in headache management. Only one (0.60%) patient required change in headache management after MRI/CT. Study results proved that, despite available evidence- based clinical guidelines, brain imaging in children with chronic headaches is overused, mostly in order to decrease anxiety of the family/patient.

Keywords

Children; Headache; Neuroimaging; Practice guidelines

Hrčak ID:

136781

URI

https://hrcak.srce.hr/136781

Publication date:

1.12.2014.

Article data in other languages: croatian

Visits: 1.670 *