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Review: history and physical examination can accurately identify migraine and the need for neuroimaging in patients with headache

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 Q In patients with headache, do features of the history and physical examination accurately identify those with migraine and those who should undergo neuroimaging?

Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ IM/Ambulatory care ★★★★★★☆ Neurology ★★★★★★☆ Emergency medicine ★★★★★☆☆

METHODS

Embedded ImageData sources:

Medline (to November 2005) and reference lists of primary studies, review articles, and textbooks.

Embedded ImageStudy selection and assessment:

studies that assessed the usefulness of history and physical examination in predicting the diagnosis of a migraine type headache using International Headache Society criteria applied by a neurologist as the gold standard, and the presence of significant intracranial pathology in adults with non-traumatic headache using neuroimaging as the gold standard. Studies assessing patients with a specific underlying chronic disease were excluded. 4 studies of migraine (n = 1210, mean age range 39–40 y, prevalence 50–89%) and 11 studies of neuroimaging (n = 3725, …

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