While certain headaches may signal serious underlying conditions, not every headache requires imaging.
Research indicates that up to 90% of imaging for headache and migraine patients reveals no abnormalities.
To minimise unnecessary radiation exposure and reduce healthcare costs, it’s important to avoid unnecessary scans.
Healthcare professionals will carefully assess your symptoms and only recommend imaging, such as MRI or CT scans, when necessary to rule out severe issues like tumours, vascular abnormalities, or structural brain problems.
Common Imaging Techniques for Headaches and Migraines
Magnetic Resonance Imaging (MRI)
MRI uses powerful magnets and radio waves to produce detailed images of the brain’s soft tissues, making it highly effective for detecting subtle abnormalities.
Common Findings
Normal in Most Migraines: MRI scans typically show no structural changes in migraine sufferers.
Potential Abnormalities
- Chiari Malformation: Displacement of brain tissue at the base of the skull.
- Brain Tumours: Abnormal growths that can compress surrounding tissues.
- Multiple Sclerosis: Scattered white matter lesions visible as bright spots on the scan.
Computed Tomography (CT) Scan
CT scans use X-rays to create cross-sectional images of the brain, providing quick and effective visualisation of acute issues like bleeding.
Common Findings
Normal in Primary Headaches: CT scans are often unremarkable in cases of migraines.
Potential Abnormalities
- Intracranial Haemorrhage: Blood accumulation in or around the brain, often appearing as a bright white area.
- Skull Fractures: Visible breaks in the skull bone.
- Brain Tumours: Masses or lesions with varying densities.
Magnetic Resonance Angiography (MRA) and Computed Tomography Angiography (CTA)
These techniques visualise blood vessels in the brain. MRA uses MRI technology, while CTA combines CT imaging with a contrast dye injected into the bloodstream.
Common Findings
Normal in Non-Vascular Causes: Blood flow appears normal in patients without vascular abnormalities.
Potential Abnormalities
- Aneurysms: Bulging, weak areas in blood vessel walls.
- Arteriovenous Malformations (AVMs): Abnormal tangles of blood vessels bypassing normal blood flow.
- Stenosis: Narrowing of blood vessels, potentially leading to reduced blood flow to certain brain regions.
Clinical Insights on the Use of Imaging
In my clinical experience as a certified Watson Headache approach practitioner at the Brisbane Headache and Migraine Clinic, imaging is not commonly required for diagnosing headaches and migraines.
Most patients respond well to our conservative treatment plans, which incorporate the Watson Headache Approach, focusing on manual therapy, exercise, and patient education.
Your headache clinician will carefully evaluate your symptoms and would refer you for further imaging only if required.
For more information on managing your headaches and migraines, visit our website or call us at 1800 432 322. We’re here to help with any questions you may have.
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References
Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018.
American Headache Society. Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults. Neurology. 2012.
Frishberg BM, et al. Evidence-based guidelines in the primary care setting: Neuroimaging in patients with nonacute headache. American Academy of Neurology. 2000.
