Headache could be the onlysymptom of brain tumour inmany cases, say researchers,suggesting that CT scans and otherneuro-imaging tests for people withheadache could prove to be helpfultools in spotting the deadly disease.The suggestions come in view ofrecent proposed guidelines in the USseeking to reduce the use of neuroimagingtests for patients withheadaches, as part of initiatives tolimit the use of unnecessary and costlymedical tests.”Although the intentions arelaudable, these guidelines areinconsistent with the neurosurgeon’sexperience with patients with braintumour,” said Ammar H. Hawasli fromWashington University’ School ofMedicine in the US.”Specifically, patients with braintumours may present with isolatedheadaches in the absence of otherneurological symptoms and signs,”added Hawasli.To illustrate the point, theresearchers analysed 95 patients with aconfirmed diagnosis of brain tumour.They found that in 11 patients,headache was the only symptom ofbrain tumour. Four of these patientshad “new-onset” headaches that wouldhave qualified them for neuro-imagingunder the recently proposed guidelines.The remaining seven patients hadmigraine or other types of headachefor which imaging may not have beenperformed under the proposed”choosing wisely” guidelines of ABIM(American Board of Internal Medicine)Foundation, the researchers said.Therefore, neuro-imaging wouldhave been delayed or never performedin three to seven percent of patientswith brain tumours.”We support careful and sensible useof neuro-imaging in which physiciansexercise excellent clinical judgment toreduce waste in the medical system,”Hawasli said.

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