American Headache Society
Numerous evidence-based guidelines agree that the risk of intracranial disease is not elevated in migraine. However, not all severe headaches are migraine. To avoid missing patients with more serious headaches, a migraine diagnosis should be made after a careful clinical history and an examination that documents the absence of any neurologic findings such as papilledema. Diagnostic criteria for migraine are contained in the International Classif...
American College of Radiology
Imaging headache patients absent specific risk factors for structural disease is not likely to change management or improve outcome. Those patients with a significant likelihood of structural disease requiring immediate attention are detected by clinical screens that have been validated in many settings. Many studies and clinical practice guidelines concur. Also, incidental findings lead to additional medical procedures and expense that do not i...
American Academy of Neurology
EEG has no advantage over clinical evaluation in diagnosing headache, does not improve outcomes and increases cost. Recurrent headache is the most common pain problem, affecting 15% to 20% of people. Occlusive carotid artery disease does not cause fainting but rather causes focal neurologic deficits such as unilateral weakness. Thus, carotid imaging will not identify the cause of the fainting and increases cost. Fainting is a frequent complain...
Patient-Friendly Resources
Imaging tests for headaches
Many people who experience severe headaches want a CT scan or MRI to see if they're caused by a brain tumor or other serious problem. But most of the time neither test is necessary. Here's why: The tests rarely help diagnose the problem. Most people who seek medical help for headaches have migraines or tension-type headaches. Those can indeed be painful, and migraines sometimes come with disturbing symptoms, like visual changes. But all that's u...
Treating migraine headaches
Migraine attacks can last for hours—or even days. They can cause intense pain, nausea, and vomiting. They can make you sensitive to light or noise, and they can affect your life and work. To treat migraines, you may get a prescription for an opioid (narcotic) or a barbiturate (sedative) called butalbital. These are pain medicines. But you should think twice about using these drugs. Here’s why: These drugs can make headaches worse. Using too mu...
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