According to a report published in JAMA Internal Medicine, about 1 in 10 people who seek outpatient care for severe headaches ultimately end up having a brain scan; either using computed tomography (CT) or magnetic resonance imaging (MRI). This is a huge number, and most of those who have a brain scan find nothing wrong. This finding supports the conclusion that researchers have come to; they think that most headache-related brain scans aren’t needed. What is needed is effective treatment.
To see just how many people suffering with severe headaches were getting CT and MRI scans, Michigan-based researchers looked at data from the National Ambulatory Medical Care Survey on physician office visits. They compiled information from over 50 million headache visits made between 2007 and 2010 and found that brain scans were conducted about 12% of the time. The cost of this was $3.9 billion, $1.5 billion of which was specifically for migraine-related scans.
Despite the cost of all of these unneeded scans, the number of headache-related brain scans undertaken is increasing. In the paper the Michigan researchers published in JAMA Internal Medicine, they reported that headache-related brain scans increased from comprising 5% of headache visits in 1995 to 14.7% in 2010.
Dr. Egilius Spierings who is a neurologist at Harvard-affiliated Brigham and Women’s Hospital has said “If people get the right treatment, meaning the one that works for them, doctors don’t feel the need to do any neuroimaging.”
Of course researchers are keen to make it clear that they are not recommending that all brain scans are stopped. After all, it can difficult not to think that there might be something really wrong when you go to the doctor with bad head pain, and after a couple of visits and a couple of different treatments tried there is still no improvement. It’s all too easy to imagine that the headache might be being caused by a bleeding artery or a tumour. For this reason, even if all the scan does is to set your mind at rest, it could very well be argued that it’s worth it.
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