Computed tomography imaging of patients with headache: Findings and clinical indications

Abstract

Purpose: To evaluate the diagnostic application of CT imaging in patients presenting with headache in an outpatient department. Materials and Methods: Medical records from a tertiary teaching hospital were retrospectively reviewed of patients presenting with headache over a period of 12 months. Patient's age, sex, duration of symptoms and abnormal rates of head CT scan were analysed using a logistic linear regression to demonstrate the relationship among these parameters. Patient's age was characterised into five groups, including under 36 years, 36-45 years, 46-55 years, 56-65 years and more than 66 years, respectively, while the duration of symptoms was also classified into five groups, namely less than 1 day, 1 to 3 days, 4 to 14 days, 15 days to 3 months and more than 3 months. Results: Of 1244 patient records reviewed, 1160 met the above criteria. 398 patients demonstrated abnormal CT findings (34.3%). There was a significant difference in the percentage of abnormal CT findings between male and female patients (p=0.04) with a male patient having 1.4 times as likely to have an abnormal CT scan relative to a female patient. The abnormal rates of head CT scan increased significantly with increasing of patient's age (p less than 0.05), with patients more than 66 years old having 31.4 times as likely to have an abnormal CT scan relative to a patient under 36 years (p less than 0.001). No significant difference was found between the abnormal CT rates and duration of symptoms (p greater than 0.05), except for the patients with a duration of symptoms more than 3 months, which was significantly lower than a patient with symptoms less than 1 day (p=0.008). Conclusion: Our results indicate that abnormal CT findings are significantly related to the patient's sex, age group, but independent of duration of symptoms. Clinical referral of CT scans to patients with headache needs to be justified.