Assessment of Appropriateness of Doing CT Scan for Investigating Headache in a Tertiary Care Hospital in Eastern India

Abstract

Background: Headache is one of the most common presenting symptoms encountered in day to day clinical practice.
A computed tomography is often the most common imaging modality to diagnose the underlying causes of headache,
majority of which turns out to be normal. The objective of this research is to study the morbidity patterns in the CT scan
reports of patients presenting with headache in the population attending a tertiary care hospital in Eastern India.
Method: The study was a retrospective analysis of all the CT scan reports performed in a tertiary care government hospital
performed for diagnostic evaluation of headache referred from different clinics and included all patients regardless of the
age during the time period December 2018 to November 2019.
Results: All the patients were classified into two groups traumatic and non- traumatic depending on the history. Out of
a total 1142 patient evaluated, 649 patients (56.83%) did not yield any positive findings on CT scan, i.e. the reports were
normal. In fact, a routine CT scan is not advised for all headache complaints even by the ACR (American College of
Radiology) appropriateness criteria. The difference between the number of patients with normal CT scan and abnormal
CT scan in both the groups was statistically significant (p< 0.05).
Conclusion: In concordance with the previous similar studies, it may be concluded that in evaluation of headache, CT
scan should be advised only in selected cases as recommended by ACR Appropriateness Criteria® Headache or any other
guidelines that may be developed for this purpose.