Magnetic Resonance Imaging Findings in Patients Referred for the Evaluation of Acute Headache to Wudassie Diagnostic Center, Addis Ababa, Ethiopia

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Addis Abeba University


Background: There is a lack of research done on imaging findings of acute headache in Ethiopia. Most studies available for cross-reference are done in developed countries and do not take into consideration clinical and epidemiologic factors unique to developing countries. Objective: To determine the most frequent imaging findings in patients presenting with acute headache and understand the association with sociodemographic and clinical factors in Ethiopia. Methodology: A retrospective cross-sectional analysis was adopted in this study. The brain MRI reports and files of 497 patients who were referred for the evaluation of acute headache (less than or equal to one month duration) to Wudassie Diagnostic Center in Addis Ababa, Ethiopia from January 2016 to September 2018 were analyzed. The demographic variables and the clinical data of the patients were correlated to the imaging findings. Data analysis was done using IBM SPSS Statistics for Windows, Version 20.0. Results: An analysis of the neurological signs and symptoms showed 38.8% of the patients referred for the evaluation of acute headache had a neurological deficit. 60% of the patients had abnormal MRI findings. Non-specific white matter lesions,(which neither explain the reason for acute headache nor alter patient outcome and management) was the most frequently observed radiologic diagnosis (16%) followed by neoplasms (11%) and infections (8%). Tuberculoma was the most frequently diagnosed infectious cause. The majority of patients with Comorbid illnesses (hypertension and HIV) had abnormal imaging findings. Age had a weak but significant positive correlation with abnormal imaging findings. Conclusions: The majority of patients who presented with acute headache had normal or minor MRI findings. The most frequent clinically significant brain MRI findings were neoplasms and infections. Older age is associated with an increased rate of abnormal imaging findings. The most common infectious cause of acute headache is found to be Tuberculoma. Recommendations: A more detailed clinical history and physical examination should be implemented to properly identify patients who are candidates for neuroimaging. Future large scale studies should be done on the imaging of acute headache in Ethiopia.



Magnetic Resonance Imaging, Acute, Headache, Ethiopia