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Computerized Tomographic Scans for Headache

Joseph D. Sargent, MD; Robert C. Lawson, MD
JAMA. 1980;244(2):133. doi:10.1001/jama.1980.03310020015007.
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To the Editor.—  In the article, "Diagnostic Evaluation of Headache: Impact of Computerized Tomography [CT] and Cost-effectiveness" (243:359, 1980), Larson et al are correct in their conclusion that CT scanning of the head in a population with headache as the primary complaint is not cost-effective in picking up intracranial mass lesions. However, such lesions have never been common in any series of patients complaining principally of headache.The provocative finding in CT scanning of the head in our headache population is the frequency of localized and generalized cerebral atrophy.1 This finding is supported by other investigators.2-5 Also, evidence for possible fresh cerebral infarcts are found when CT scans are done during the headache phase. It is too early to close the issue regarding the importance of these findings by saying CT scanning of the head is not cost-effective in a headache population. An ongoing appraisal of these findings

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