{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:25:08Z","timestamp":1740126308509,"version":"3.37.3"},"reference-count":11,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,10,9]],"date-time":"2017-10-09T00:00:00Z","timestamp":1507507200000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001543","name":"Neurological Foundation of New Zealand","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001543","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Headache is a common patient complaint. The threshold for brain imaging in headache is debated, especially when the headache is transient, although even if the headache has resolved at presentation, a sentinel bleed heralding a subarachnoid haemorrhage (<jats:styled-content style=\"fixed-case\">SAH<\/jats:styled-content>) often remains a concern.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess the yield of computed tomography (<jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>) head scan referrals for patients with transient headache symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study looked at 6 months of <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> results in order to assess for brain pathology, with a particular focus on subarachnoid haemorrhage. Where any pathology was identified, detailed chart review looked for potential high\u2010risk indicators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between January and July 2015, 531 undifferentiated headache patients were referred for head <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>. Of these, 177 (33.3%) presented with a transient or episodic pattern. None of these cases had <jats:styled-content style=\"fixed-case\">SAH<\/jats:styled-content> on imaging nor re\u2010presented with <jats:styled-content style=\"fixed-case\">SAH<\/jats:styled-content> within 3 months of initial <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>. However, 7.3% (13\/177) had other significant intracranial pathologies. The only significant risk factor for <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> abnormality in this setting was focal neurology on presentation (odds ratio 3.1 (95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 1.2\u201311.0); <jats:italic>P<\/jats:italic>\u2009=\u20090.044). All identified cases of <jats:styled-content style=\"fixed-case\">SAH<\/jats:styled-content> over the 6\u2010month study period occurred in patients with persistent headache, and their clinical presentations showed a similar cluster of symptoms to previous literature (including thunderclap headache, vomiting and loss of consciousness).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study suggests that patients with transient headache are at a low risk of <jats:styled-content style=\"fixed-case\">SAH<\/jats:styled-content>; however, further study is needed to quantify this, and other serious pathologies remains a concern, especially in the setting of focal neurology at presentation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.13517","type":"journal-article","created":{"date-parts":[[2017,6,7]],"date-time":"2017-06-07T08:15:55Z","timestamp":1496823355000},"page":"1141-1146","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Yield of head computed tomography in patients with new onset of transient headaches"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7332-168X","authenticated-orcid":false,"given":"Niamh","family":"Hammond","sequence":"first","affiliation":[{"name":"Department of Medicine University of Otago  Wellington New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3223-3330","authenticated-orcid":false,"given":"Annemarei","family":"Ranta","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Otago  Wellington New Zealand"},{"name":"Department of Neurology Capital and Coast District Health Board  Wellington New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,10,9]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.7.866"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-2982.2002.00368.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c5204"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.65.5.791"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(04)00709-4"},{"key":"e_1_2_6_7_1","unstructured":"Singer RJ Ogilvy CS Rordof G. Clinical manifestations and diagnosis of subarachnoid haemorrhage. In: Biller J Wilterdink J Waltham MA eds.UpToDate;2013[cited 2015 Aug 26]. Available from URL:https:\/\/www.uptodate.com\/contents\/clinical\u2010manifestations\u2010and\u2010diagnosis\u2010of\u2010aneurysmal\u2010subarachnoid\u2010hemorrhage?source=search_result&search=Clinical%20manifestations%20and%20diagnosis%20of%20subarachnoid%20haemorrhage&selectedTitle=1~150"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102413485658"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(89)80059-9"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-2982.2003.00596.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra052732"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)91970-4"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fimj.13517","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.13517","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/imj.13517","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.13517","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T08:25:39Z","timestamp":1693556739000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.13517"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10]]},"references-count":11,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2017,10]]}},"alternative-id":["10.1111\/imj.13517"],"URL":"https:\/\/doi.org\/10.1111\/imj.13517","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"type":"print","value":"1444-0903"},{"type":"electronic","value":"1445-5994"}],"subject":[],"published":{"date-parts":[[2017,10]]},"assertion":[{"value":"2017-04-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-05-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-10-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}