$1 billion a year is spent on brain scans for headache sufferers

Guidelines warn doctors against using brain scans for routine headache and migraine cases. Despite this, 12% of patients presenting with headache to a doctor are given scans, according to a study by researchers at the University of Michigan Medical School.

Since the guidelines discouraging the use of magnetic resonance imaging (MRI) and computed tomography (CT) scans for headache were published, scans have become more - rather than less - common for headache sufferers.

Headaches can sometimes be a symptom of a more serious illness, such as a brain tumor, aneurysm or arteriovenous malformation. Doctors might order an MRI or CT scan to put their patients' minds at ease, or even to protect themselves legally if their patient requests a scan.

But previous research has shown that only 1-3% of brain scans of headache patients uncover a malignant growth or problem with the blood vessels in the brain. Also, of these issues found by scans, many do not require immediate treatment.

"There's solid research showing that the number of times you find serious issues on these scans in headache patients is about the same as that for a randomly chosen group of non-headache patients," says Dr. Brian Callaghan, lead author on the study, which is published in JAMA Internal Medicine. "And a lot of the things we find on such scans aren't necessarily something we will do something about."

That the scans have become more widely used for headaches in the face of medical opinion could mean that the rise has been driven by patients putting pressure on their doctors. As such, Dr. Callaghan's team recommends better education for the public on headaches and the recommended applications of brain scans.

The team also suggests that redesigning insurance plans to require patients to pay part of the cost for the scan may discourage unnecessary use of this technology.

$1billion a year cost of scans is 'a conservative estimate'