{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T08:21:47Z","timestamp":1774167707210,"version":"3.50.1"},"reference-count":20,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T00:00:00Z","timestamp":1742947200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurology International"],"abstract":"<jats:p>Background\/Objectives: Headache is one of the most common neurological symptoms associated with COVID-19, affecting approximately 25% of patients. While most headaches resolve within weeks, some persist for months, suggesting underlying structural brain changes. This study aimed to identify brain MRI abnormalities associated with chronic headaches in patients with a history of COVID-19 infection. Methods: This retrospective study included 30 patients with post-COVID-19 headaches and 30 control patients with no history of COVID-19. Demographic characteristics were analyzed using t-tests and chi-square tests. MRI findings were categorized into six types: cortical atrophy, white matter lesions, vascular lesions, lacunar lesions, vascular encephalopathy, and sinusitis. Differences in MRI findings between the two groups were evaluated using chi-square tests. Secondary outcomes included the analysis of symptoms accompanying headaches, diagnoses following MRI, and treatments applied. Results: White matter lesions were significantly more frequent in the post-COVID-19 group (50%) compared to controls (20%) (p = 0.015). Conversely, sinusitis was more prevalent in the control group (36.7%) than in the post-COVID-19 group (6.7%) (p = 0.005). Other MRI abnormalities showed no significant differences. Cognitive dysfunction (30%) and dizziness (33.3%) were the most common associated symptoms. The most frequent diagnoses after MRI in the post-COVID-19 group were headaches\/migraines (23.3%), post-COVID-19 headache (20%), and vestibular syndrome (13.3%). Conclusions: Persistent post-COVID-19 headaches may be linked to structural white matter changes observed in MRI. Further research, ideally including pre-infection imaging data, is needed to determine the causal relationship between these lesions and chronic headache symptoms. Trial Registration: This study was registered in ClinicalTrials with the trial registration number NCT06825741 on 13 February 2025.<\/jats:p>","DOI":"10.3390\/neurolint17040050","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T06:06:35Z","timestamp":1743141995000},"page":"50","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Brain Structural Abnormalities in Patients with Post-COVID-19 Headache"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7463-7608","authenticated-orcid":false,"given":"Klaudia","family":"Sz\u00e9phelyi","sequence":"first","affiliation":[{"name":"Doctoral School of Health Sciences, Faculty of Health Sciences, University of P\u00e9cs, 7622 P\u00e9cs, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1787-3711","authenticated-orcid":false,"given":"Szilvia","family":"K\u00f3ra","sequence":"additional","affiliation":[{"name":"Doctoral School of Health Sciences, Faculty of Health Sciences, University of P\u00e9cs, 7622 P\u00e9cs, Hungary"},{"name":"Faculty of Health Sciences and Social Studies, Department of Theoretical Health Sciences and Health Management, University of Szeged, 6726 Szeged, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gergely","family":"Orsi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical School, University of P\u00e9cs, 7622 P\u00e9cs, Hungary"},{"name":"HUN-REN-PTE Clinical Neuroscience MR Research Group, Hungarian Research Network, 7622 P\u00e9cs, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7607-6739","authenticated-orcid":false,"given":"J\u00f3zsef","family":"Toll\u00e1r","sequence":"additional","affiliation":[{"name":"Doctoral School of Health Sciences, Faculty of Health Sciences, University of P\u00e9cs, 7622 P\u00e9cs, Hungary"},{"name":"Somogy County M\u00f3ricz Kaposi Teaching Hospital, 7400 Kaposv\u00e1r, Hungary"},{"name":"Digital Development Center, Sz\u00e9chenyi Istv\u00e1n University, 9026 Gy\u0151r, Hungary"},{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, University of P\u00e9cs Medical School, 7622 P\u00e9cs, Hungary"},{"name":"J\u00e1nos Bolyai Research Scholarship of the Hungarian Academy of Science, 1051 Budapest, Hungary"},{"name":"Faculty of Health Sciences, University of P\u00e9cs, 7622 P\u00e9cs, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.ejim.2021.06.009","article-title":"Prevalence of post-COVID-19 symptoms in hospitalized and non-hospitalized COVID-19 survivors: A systematic review and meta-analysis","volume":"92","author":"Florencio","year":"2021","journal-title":"Eur. 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