Daily Health Headlines

Too Many Unneeded Brain Scans for Headaches, Study Suggests

👤by Steven Reinberg 0 comments 🕔Tuesday, March 18th, 2014

MONDAY, March 17, 2014 (HealthDay News) -- Too many patients are getting unnecessary brain scans for headaches, and that use is growing, according to a new study.

Since most headaches are benign, guidelines have recommended against routine MRIs or CT scans. Yet doctors frequently order these expensive scans anyway, the researchers say.

"During headache visits, brain scans are ordered an incredible amount of the time," said lead researcher Dr. Brian Callaghan, an assistant professor of neurology at the University of Michigan Health System, in Ann Arbor.

"There are a lot of MRIs and a lot of CTs and that adds up to a lot of money," he pointed out. "It's about $1 billion a year."

Brain scans for headaches jumped from about 5 percent of patient visits in 1995 to nearly 15 percent in 2010, the researchers found.

While brain scans are good for some patients, they are unnecessary for most, Callaghan noted. "Most people with headaches don't need any testing," he said.

Among the reasons these tests are not recommended is that they can often find some abnormality, which although benign, could lead to further unnecessary tests and treatment, he explained.

"In 1 to 3 percent of people you will find something on the MRI, whether it be a tumor or blood vessel malformation. You don't want to find something you weren't looking for. It can be anxiety provoking," Callaghan said.

Brain scans can cost as much as $4,000. Insurance, including Medicare, only pays from $500 to $2,000, Callaghan said.

For the study, Callaghan's team used data from a national survey on outpatient medical care to look at all adult patients seen for headache from 2007 through 2010. Most patients were younger than 65 and about three-quarters were women.

The study found there were a total of roughly 51 million patient visits for headache, including about 25 million for migraines. MRIs or CTs were performed in more than 12 percent of all visits for headache and in nearly 10 percent of visits for migraine.

The researchers estimated the cost of all these scans in the four-year period at $3.9 billion.

"The number-one reason physicians give is patient reassurance. It's harder to talk a patient out of it than to just get the scan," Callaghan said. "But I would argue that patient reassurance isn't worth $1 billion a year."

In addition, doctors order scans out of fear they might miss a serious condition and be sued for misdiagnosis, he noted.

The profit motive also comes into play, Callaghan added. "Facilities make a lot of money off of these tests," he said.

Patients also have a role, Callaghan said. "Imaging for headaches is on the list of tests patients should question," he said.

The report was published online March 17 as a research letter in JAMA Internal Medicine.

Guidelines from the American Academy of Family Physicians, American Academy of Neurology and the American College of Emergency Physicians recommend against routine brain scans for headache (in the absence of other indications).

The study could not verify whether scans were ordered according to guidelines or not, but showed that they occurred in the context of a headache-related visit to a doctor.

"Though this study shows levels of imaging that are undoubtedly excessive and costs that almost certainly exceed the benefits, it does not measure or discuss the benefits of brain imaging in patients with headache," said Dr. Richard Lipton, vice chairman of neurology and director of the Montefiore Headache Center at the Albert Einstein College of Medicine, in New York City.

These benefits include finding a brain tumor, stroke, brain abscess and bleeding into the brain, according to Lipton, who was not involved with the new study. Reassuring worried patients that they do not have a serious or life-threatening condition is important, he said.

In addition, scans reduce the doctor's concern that they might have missed a serious condition, as well as concerns about the liability that may arise from a failure to diagnose.

"The reality is that most headaches are benign, but distinguishing high-risk and low-risk presentations is not that easy," Lipton said. "I agree that optimizing headache brain imaging practices should be a priority."

Article Credits / Source

Steven Reinberg / HealthDay

Steven Reinberg wrote this story for HealthDay. HealthDay provides up to the minute breaking health news. Click here to view this full article from HealthDay.

SOURCES: Brian Callaghan, M.D., assistant professor of neurology, University of Michigan Health System, Ann Arbor; Richard Lipton, M.D., vice chairman, neurology, and director, Montefiore Headache Center, Albert Einstein College of Medicine, New York City; March 17, 2014, JAMA Internal Medicine, online

View More Articles From Steven Reinberg 🌎View Article Website

Sponsored Product

Lunar Sleep for $1.95

Lunar Sleep for $1.95

People who have trouble sleeping typically have low levels of melatonin, so melatonin supplements seem like a logical fix for insomnia. There is a high demand for sleep aids, especially in the U.S. The National Health Interview Survey done in 2002, and again in 2007, found 1.6 million US adults were using complementary and alternative sleep aids for insomnia. Lunar Sleep was a top choice. Use Promo Code: Sleep2014 and only pay $1.95 S&H.

Get Lunar Sleep for $1.95

More Migraine Headaches Articles

Migraine and Stroke Risk Linked Again

Migraine and Stroke Risk Linked Again0

TUESDAY, Nov. 15, 2016 (HealthDay News) -- Women who experience migraines have more than double the risk of suffering a stroke, new research shows. The finding adds evidence to the suspected link between these two conditions. Although it's not ...

Study Questions Use of Migraine Meds in Kids, Teens

Study Questions Use of Migraine Meds in Kids, Teens0

THURSDAY, Oct. 27, 2016 (HealthDay News) -- A new study raises questions about the effectiveness of medicines commonly prescribed to prevent migraines in children and teens. The 24-week clinical trial involving 328 patients found no significant ...

More Kids and Teens Heading to ER With Headaches

More Kids and Teens Heading to ER With Headaches0

FRIDAY, Oct. 21, 2016 (HealthDay News) -- A growing number of American children with headaches are being seen at pediatric emergency departments and admitted to the hospital, researchers report. The researchers at the Children's Hospital of ...

Mouth and Gut Germs May Be Linked to Migraines

Mouth and Gut Germs May Be Linked to Migraines0

TUESDAY, Oct. 18, 2016 (HealthDay News) -- People with migraines have higher levels of certain microbes, or germs, in their mouths and digestive systems, new research suggests. Specifically, the analysis of data from the American Gut Project ...

For Migraine Sufferers, Is a Chiropractor's Touch All in the Mind?

For Migraine Sufferers, Is a Chiropractor's Touch All in the Mind?0

TUESDAY, Oct. 11, 2016 (HealthDay News) -- People with migraines sometimes seek a chiropractor for help, but a small study suggests that any pain relief they get might be a placebo effect. When researchers pitted real chiropractic manipulation ...

View More Migraine Headaches Articles

0 Comments

Write a Comment

Your email address will not be published. Required fields are marked *

Our Mailing List

Subscribe to our mailing list to get the latest health news as it breaks!

Your information will not be shared with anyone!