Imaging in the Evaluation of Headache

Headache is a common symptom with a wide differential and can be due to hundreds of causes. The frequency of pathologic conditions that present with headache is rather low and most headaches are due to benign primary headache disorders. The overall yield of neuroimaging studies for headache without an abnormality on neurologic examination is low. Secondary causes of headache can have devastating consequences or important treatment implications, thus it is important to differentiate between secondary and primary headache disorders. This article reviews when and how to use imaging for headaches, and what abnormalities may be found on these studies.