In a study by Yilmaz et al [12] of 449 children with headache, approximately 55% of children had migraine, 30% had tension-type headaches, 10% had secondary headaches, and 5% were unspecified. Twenty-one percent of imaged children (n = 324) had abnormalities identified on their magnetic resonance imaging (MRI) examinations, largely incidental findings, with <1% having relevant findings to explain the headache, namely tumor with hydrocephalus. Similarly, Martens et al [11] found that even though some neurological signs were present in a substantial number of children with primary headaches, mostly migraines, the yield of brain MRI scans was still low. Therefore, the yield of brain MRI is not contributory to the diagnostic and therapeutic approach in children with primary headaches. Based on analysis of a large body of evidence, the practice parameters authored by the American Academy of Neurology and Child Neurology Society recommend considering neuroimaging in children with an abnormal neurologic examination (eg, focal findings, signs of increased intracranial pressure, significant alteration of Reprint requests to: publications@acr.org Advanced imaging modalities such as computed tomography (CT) and MRI are preferred when neuroimaging in children is considered. CT exposes children to radiation, whereas MRI sometimes requires sedation or general anesthesia, especially in children <6 years of age. Therefore, neuroimaging should be reserved for children with a suspicious clinical history, abnormal neurological findings, or other physical signs suggestive of significant intracranial pathology [7,9]. CT In most cases, CT is usually not the study of choice for imaging children with headaches. However, there are some cases when a CT scan of the head is indicated because of its speed and sensitivity for detecting acute blood products.
Headache Child PCAs. In a study by Yilmaz et al [12] of 449 children with headache, approximately 55% of children had migraine, 30% had tension-type headaches, 10% had secondary headaches, and 5% were unspecified. Twenty-one percent of imaged children (n = 324) had abnormalities identified on their magnetic resonance imaging (MRI) examinations, largely incidental findings, with <1% having relevant findings to explain the headache, namely tumor with hydrocephalus. Similarly, Martens et al [11] found that even though some neurological signs were present in a substantial number of children with primary headaches, mostly migraines, the yield of brain MRI scans was still low. Therefore, the yield of brain MRI is not contributory to the diagnostic and therapeutic approach in children with primary headaches. Based on analysis of a large body of evidence, the practice parameters authored by the American Academy of Neurology and Child Neurology Society recommend considering neuroimaging in children with an abnormal neurologic examination (eg, focal findings, signs of increased intracranial pressure, significant alteration of Reprint requests to: publications@acr.org Advanced imaging modalities such as computed tomography (CT) and MRI are preferred when neuroimaging in children is considered. CT exposes children to radiation, whereas MRI sometimes requires sedation or general anesthesia, especially in children <6 years of age. Therefore, neuroimaging should be reserved for children with a suspicious clinical history, abnormal neurological findings, or other physical signs suggestive of significant intracranial pathology [7,9]. CT In most cases, CT is usually not the study of choice for imaging children with headaches. However, there are some cases when a CT scan of the head is indicated because of its speed and sensitivity for detecting acute blood products.