COMPUTED TOMOGRAPHIC SCANNING IN PATIENTS PRESENTING WITH CHIEF COMPLAINT OF HEADACHE WITHOUT FOCAL NEUROLOGICAL SIGNS

Computed Tomographic Scanning in Patients With Headache

Abstract

Objective: To determine the frequency of positive computed tomographic (CT)scan findings in patients presenting at PNS Shifa Hospital Karachi with chief complaint of headache without focal neurological signs.
Study Design: Cross sectional descriptive study.
Place and Duration of Study: The study was conducted at the Radiology department, PNS Shifa Hospital Karachi from Dec2011 to Jun2012.
Patients and Methods: This cross-sectional descriptive study included referred patients with complaint of headache of one month duration or more without focal neurological signs. No gender restriction was considered and patients of age more than 14 years were included. Patients with headache due to other known clinical disorders such as intracranial neoplasm and stroke were excluded. Patients with focal neurological signs such as hemiparesis, cerebellar signs and cranial nerve palsies were also excluded from the study. A total of 105 patientswere included in the study through non probability consecutive sampling. Informed written consent was taken from the patients by explaining all the risks and benefits of the study and use of data for research and publication. Plain CT scan brain was done by trained CT technician and reporting of CT scan was done by consultant radiologist. CT scan was done on Toshiba Scanner Aquilion-64 CT Scan machine. The imaging protocol consisted of appropriately angled continuous 5mm thick axial slices for the posterior fossa and 10 mm thick slices for the rest of brain from the base of skull to the vertex. Data was collected through a specially structured proforma. Confidentiality of the patients’ record was maintained.
Results: Majority of the patients were between 31-40 years of age i.e. 29.52% (n=31) and mean and SD was calculated as 34.24 ± 8.72 years, 54.29% (n=57) females and 45.71% (n=48) male patients, frequency of positive CT scan findings in patients with chief complaint of headache without focal neurological signs was recorded as 14.29% (n=15).
Conclusion: The frequency of positive CT scan findings in patients presenting at PNS Shifa Hospital Karachi with chief complaint of headache without focal neurological signs was low. Due to potential risk of cancer from exposure to ionizing radiations, efforts should be made to avoid CT scanning for headache when the likelihood of serious illness is low.