Paediatric Headaches and Neuroimaging

Questions marked with an * are required

* Are you:

* Do you consider imaging in a patient that presents with intermittent headache and a normal neurological exam?

Yes

* Do you consider imaging when a patient has headaches of less than 1 month duration?

Yes

* Do you consider imaging in a patient that has a normal neurological exam but has persistent headaches WITHOUT a family history of migraine?

Yes

* Do you consider imaging in a patient with new onset of severe episodes or change in type of headache?

Yes

* Which of the following symptoms/ signs or aspects of the history would prompt you to order neuroimaging as part of the initial work-up of a child presenting to A&E with a headache? Select all that apply.

* In your opinion what are the main challenges that prevent you from referring a child for neuroimaging? Select all that apply.

Practical challenges (e.g. procedural difficulty, patient and parent anxiety, movement restriction)

Technical obstacles: access; availability of child appropriate equipment, masking and attenuation of scanner background noise)

Availability

Choice of most appropriate analysis methods

Potential need for sedation

Exposure to radiation

Benign findings

Cost-effectiveness

* Please rank (1-4) the following interventions in the order you would use in a child complaining of migraine of less than 6 months duration, assuming no co-morbidities

Lifestyle modification
Headache diary
Medication including analgesia
Neuroimaging

* Approximately how many children presenting with headaches have you referred for neuroimaging in the past 12 months?