Ct scan findings in patients presenting with headache at the radiology department Muhimbili national hospital, in Dar es Salaam, Tanzania

Abstract

Background It is estimated that more than one hundred thousand people suffer from headache all over the world. Headache is one of the main sources of discomfort. The IHS classifies headache into primary (without any organic cause) or secondary (with an established cause an established cause). Primary headache includes migraine, cluster. With these types of headaches no imaging modality has proved to be necessary. With current literature, the migraine headache can be investigated with MRI and gives positive results. For secondary type of headache hemorrhage has been established as one of the factors. This is attributed to hypertension which is on the rise in Tanzania. Other factors include brain atrophy and tumors which can be primary or secondary. Objectives To evaluate the causes of secondary headache by the use of CT scan at MNH in 2011. This will help to determine the most prevalent cause of headache in patients. Also to determine the most prevalent cause of headache in general and the pattern of presentation on the imaging modality. Methodology This was an observational study whereby a sample of 85 subjects were taken. Characteristic of the type of headache was noted as documented in the request form. The underlying conditions were outlined. Evaluation for the cause of headache was done using a helical PHILLIPS CT 8 planner scan machine (Phillips, Eindhelsen, Netherlands).Collected data was analyzed using SPSS programme version 15. For the continuous data mean and standard deviation were considered while for the categorical was by proportion and percentage. The association between headache and the risk factors will be established using chi square and linear regression to establish the statistical significance. Results The study included 85 patients, with more females than males. The study showed that the prevalence of positive findings among patients that presented with headache was 31.9%. The most prevalent pathology found was sinusitis which was located in the maxillary sinus. Among the CT scan findings and the suspected diagnosis, brain metastasis showed to have strong correlation. Both sinusitis, brain atrophy and brain infection had positive correlation and brain infarction had negative correlation between the clinical deduced diagnosis and the CT scan findings. Some study subjects had pre existing morbidity and the most frequent one was hypertension. No significant difference was noted among patients who had hypertension and those who had not as far as the CT SCAN findings (P 4.254). There were neurological complaints apart from headache and the commonest one documented was loss of consciousness. This however did not have an effect on the CT scan findings whether normal or abnormal (P 0.016).Conclusion CT scan has a role in determining the cause of headache. Primary headache is more common than secondary headache. More emphasis should be put to women presenting with headache. The commonest cause of secondary headache is maxillary sinusitis. ix Recommendations More emphasis should be given to female patients presenting with headache especially above the age of 40. Also cancer patients should undergo CT scan when presenting with first time headache due to high likelihood having brain metastasis.