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US headache sufferers get $1 billion worth of brain scans each year, U-M study finds
Date:3/17/2014

be used," says Brian Callaghan, M.D., M.S., the U-M neurologist who led the team performing the study.

"Lots of guidelines say we shouldn't do this including ones from neurology and radiology groups but yet we still do it a lot. This is a source of tremendous cost in health care without a lot of evidence to justify the cost," he notes.

A billion dollars' worth of reassurance?

Doctors might order a CT or MRI scan for a headache or migraine to put patients' minds at ease about fears that a malignant brain tumor, aneurysm, arteriovenous malformation or other issue might be causing their symptoms.

And even if the patient doesn't meet the conditions that guidelines say can benefit most from brain imaging for instance, someone with an abnormal neurological exam or a known cancer -- doctors might order a scan at a patient's request to protect themselves legally.

But past research shows that only 1 percent to 3 percent of scans of patients with repeated headaches find that a growth or blood vessel problem in the brain is to blame. And many of the issues that scans spot turn out not to pose a serious threat or may not require treatment right away.

"There's solid research showing that the number of times you find serious issues on these scans in headache patients is about the same as that for a randomly chosen group of non-headache patients," he says. "And a lot of the things we find on such scans aren't necessarily something we will do something about."

Callaghan notes that the current study, based on data from the Centers for Disease Control & Prevention's National Ambulatory Care Medical Survey, couldn't detect which scans met guidelines and which didn't.

But the fact that 14.7 percent of people who saw a doctor for headache or migraine in 2010 went on to have a brain scan would not be expected if guidelines were being followed, he says. The team is working on further research into t
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
Source:Eurekalert

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