- Other studies found similar risk of abnormalities in children with
headaches and normal physical and neurologic examination.2
- Most cost effective strategy depends upon the probability of tumor-for
low risk children recommended close follow up, for intermediate risk
recommended CT followed by MRI for any positive results, for high risk
- Predictors of space-occupying lesions include: Sleep-related HA, no
family history of migraine, no visual symptoms, duration of headache
< 6 mo, abnormal neuro exam, vomiting, and confusion.4
Maytal J, Bienkowski RS, Patel M, Eviatar L. The value of brain imaging
in children with headaches. Pediatrics 1995;96:413-416.
Lewis DW, Dorbad D. The utility of neuroimaging in the evaluation of
children with migraine or chronic daily headache who have normal neurologic
examinations. Headache 2000;40:629-632.
Medina S, Kuntz K, Pomeroy S. Children with headache suspected of having
a brain tumor: a cost-effectiveness analysis of diagnostic strategies.
Medina S, Pinter JD, et al. Children with headache: clinical predictors
of surgical space-occupying lesions and the role of neuroimaging. Radiology