Skip to main content

When to image neurologically normal children with headaches: development of a decision rule

Buy Article:

$51.00 plus tax (Refund Policy)


Abstract Aims: 

The aim of this study was to develop and refine a decision rule on when to undertake brain imaging (BI) in neurologically normal children with headaches. Methods: 

From the literature and a questionnaire study, a list of red flags (RFs) was drawn-up. During the prospective 4-year period, consecutive children with headache were classified according to RFs and the headache diagnosis. Result: 

Three of 709 (0.4%) neurologically normal children had significant brain abnormalities. BI was carried out in 389 of 498 (78%) children with RFs. Significant abnormalities were found in three of 389 children (0.8%), all had unclassified headache (UH). BI was not arranged for the 211 children with no RFs. None of these developed RFs or abnormal signs on follow-up for a mean of 13 months. Conclusion: 

In addition to BI for those with neurological signs, we think BI should be considered for neurologically normal patients with UH and RFs. This would have saved imaging children needlessly: only 101 of 709 (14%) would have had scans arranged, instead of 389 of 709.

Keywords: Brain imaging; Children; Decision rule; Headache; Red flags

Document Type: Research Article


Affiliations: 1: .Paediatric Department, Queen’s University Hospital, London, UK 2: .Paediatric Neurology, The Royal London Hospitals, London, UK 3: .Department of Neuroradiology, Great Ormond Street Hospital, London, UK 4: .School of Human Development, University of Nottingham, Nottingham, UK

Publication date: June 1, 2010


Access Key

Free Content
Free content
New Content
New content
Open Access Content
Open access content
Subscribed Content
Subscribed content
Free Trial Content
Free trial content
Cookie Policy
Cookie Policy
ingentaconnect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more