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Research ArticleOriginal Article
Open Access

Common diagnoses and factors associated with abnormal neuroimaging in headache patients in the emergency department

Mohammed H. Alanazy, Hassan Almalak, Malak Alaboudi, Abdullah Abujamea, Abdul Albilali and Taim Muayqil
Neurosciences Journal January 2023, 28 (1) 36-41; DOI: https://doi.org/10.17712/nsj.2023.1.20220042
Mohammed H. Alanazy
Department of Internal Medicine (Alanazy, Almalak, Alaboudi, Albilali, Muayqil), College of Medicine, King Saud University, from the Department of Radiology and Medical Imaging (Abujamea), King Saud University Medical City & College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
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Hassan Almalak
Department of Internal Medicine (Alanazy, Almalak, Alaboudi, Albilali, Muayqil), College of Medicine, King Saud University, from the Department of Radiology and Medical Imaging (Abujamea), King Saud University Medical City & College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
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  • For correspondence: [email protected]
Malak Alaboudi
Department of Internal Medicine (Alanazy, Almalak, Alaboudi, Albilali, Muayqil), College of Medicine, King Saud University, from the Department of Radiology and Medical Imaging (Abujamea), King Saud University Medical City & College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
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Abdullah Abujamea
Department of Internal Medicine (Alanazy, Almalak, Alaboudi, Albilali, Muayqil), College of Medicine, King Saud University, from the Department of Radiology and Medical Imaging (Abujamea), King Saud University Medical City & College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
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Abdul Albilali
Department of Internal Medicine (Alanazy, Almalak, Alaboudi, Albilali, Muayqil), College of Medicine, King Saud University, from the Department of Radiology and Medical Imaging (Abujamea), King Saud University Medical City & College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
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Taim Muayqil
Department of Internal Medicine (Alanazy, Almalak, Alaboudi, Albilali, Muayqil), College of Medicine, King Saud University, from the Department of Radiology and Medical Imaging (Abujamea), King Saud University Medical City & College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
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Article Figures & Data

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    Table 1

    - Patients’ characteristics at the time of presentation.

    Variablesn (%)
    Women219 (66.6)
    Age, mean (SD) years39.7 (18.4)
    Post-partum10 (3.0)
    Pregnancy12 (3.6)
    Oral Contraceptive use13 (4.0)
    Known migraineurs28 (8.5)
    Previous neurological disease48 (14.6)
    Previous stroke16 (4.9)
    Seizures10 (3.0)
    Known idiopathic intracranial hypertension7 (2.1)
    Other16 (4.9)
    Hypertension73 (22.2)
    Diabetes Mellitus63 (19.1)
    Connective tissue disease34 (10.3)
    Known hypercoagulable state4 (1.2)

    Data are number (%) unless otherwise noted

      • View popup
      Table 2

      - Headache characteristics and neurological examination findings.

      Variablesn (%)
      Onset after age of 50 years66 (20.1)
      Headache severity
      Mild to moderate23 (7.0)
      Severe120 (36.5)
      Missing186 (56.5)
      Headache character
      Throbbing82 (24.9)
      Compressing40 (12.2)
      Dull or achy8 (2.4)
      Stabbing5 (1.5)
      Missing194 (59.0)
      Headache location
      Temporo-parietal63 (19.1)
      Holo-cephalic46 (14.0)
      Occipital37 (11.2)
      Bitemporal30 (9.1)
      Frontal20 (6.1)
      Retro-orbital8 (2.4)
      Missing125 (38.0)
      Headache onset
      <1 week102 (31.0)
      1 week to 1 month45 (13.7)
      >1 month51(15.5)
      Missing131(39.8)
      Headache duration >4 hours26 (7.9)
      Neck pain49 (14.9)
      Neurological signs144(43.8)
      Papilledema35 (10.6)
      Sensory abnormality24 (7.3)
      Weakness23(7.0)
      Seizure13 (4.0)
      Cranial nerve palsy14(4.3)
      Visual disturbance11(3.3)
      Dysarthria or aphasia7(2.1)
      Other17 (5.2)

      Data are number (%) unless otherwise noted

        • View popup
        Table 3

        - Imaging modality and diagnoses (n=329).

        Variablesn (%)
        Neuroimaging performed
        CT head262 (79.6)
        MRI brain255 (77.5)
        Both CT and MRI188 (57.1)
        Abnormal neuroimaging105 (31.9)
        Final diagnosis as reported
        Primary headache54 (16.4)
        Migraine47 (14.3)
        Tension-type5 (1.5)
        Cluster1(.3)
        Hemicrania continua1(.3)
        Secondary headache160 (48.6)
        Idiopathic intracranial hypertension33 (10.0)
        Ischemic stroke21 (6.4)
        Brain tumor19 (5.8)
        Intracranial hemorrhage13 (4.0)
        CNS infection12 (3.6)
        Cerebral venous thrombosis10 (3.0)
        Other52 (15.8)
        Non-specific headache115 (35.0)

        Data are number (%) unless otherwise noted

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        Common diagnoses and factors associated with abnormal neuroimaging in headache patients in the emergency department
        Mohammed H. Alanazy, Hassan Almalak, Malak Alaboudi, Abdullah Abujamea, Abdul Albilali, Taim Muayqil
        Neurosciences Journal Jan 2023, 28 (1) 36-41; DOI: 10.17712/nsj.2023.1.20220042

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        Common diagnoses and factors associated with abnormal neuroimaging in headache patients in the emergency department
        Mohammed H. Alanazy, Hassan Almalak, Malak Alaboudi, Abdullah Abujamea, Abdul Albilali, Taim Muayqil
        Neurosciences Journal Jan 2023, 28 (1) 36-41; DOI: 10.17712/nsj.2023.1.20220042
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