López BMW, Guerrero AGML

Language: Spanish
References: 18
Page: 153-160
PDF size: 516.90 Kb.

ABSTRACT

Background. Cephalea is one of the leading causes of medical consultation in the world, with over 90% prevalence, making accurate identification through detailed clinical history and physical examination essential. Only a minority of patients with cephalea can be expected to develop a significant illness. Neuroimaging studies such as cranial computed tomography are recommended in patients in whom doctors seek to rule out a secondary cause of cephalea, in cases with atypical, first time cephalea or exacerbation of existing cephalea, and when abnormalities are detected by physical examination, among others. Notwithstanding, some investigators suggest that neuroimaging studies rarely contribute to the diagnosis of this condition.
Purpose. Show the usefulness of cranial computed tomography, in simple and contrasted phase, in the search for structural anomalies in patients with cephalea without associated neurological alteration at Hospital General de Mexico.
Material and methods. The interpretations of cranial computed tomographies, in simple and contrasted phase, taken in patients with diagnosis of cephalea under study sent to the Hospital General de Mexico Radiology and Image Service without distinction of age or gender, without the presence of neurological alterations and without antecedents of cranial surgery, were analyzed in the period from August 1, 2010, through June 30, 2011.
Results. Eighty-one cranial computed tomographies in simple and contrasted phase were taken. Most of the patients were female (53 women, 65.5%) and the majority of cases were in the age range of 20 to 39 years. The most common report was absence of lesions (46 cases, 56.7%) followed by loss of cerebral volume (17.7%) and calcified granulomas of probable parasitic origin (8.6%). Other interesting findings include a case with aneurism of the middle cerebral artery and studies in which only sinusitis was observed.
Discussion. In recent years there has been an increase in the use of computed tomography in diagnosis of cephalea. Most of the patients with cephalea studied had no clinically significant findings in this image study; the most frequently reported include calcified granulomas of probable parasitic origin, indications of endocranial hypertension (as well as a case of aneurism of the middle cerebral artery and another with communicating hydrocephalus found in this investigation). Our results are similar to those reported by other authors. On the other hand, we did not observe that administration of endovenous contrast medium provided additional information to that obtained in the simple phase.
Conclusions. Cranial computed tomography is part of the study protocol in patients with cephalea due to its greater accessibility and low cost; its main usefulness lies in ruling out the presence of structural alterations as secondary causes of head ache.

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