New diagnostic criteria for headache attributed to transient ischemic attacks
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New diagnostic criteria for headache attributed to transient ischemic attacks. / Lebedeva, Elena R; Gurary, Natalia M; Olesen, Jes.
I: The Journal of Headache and Pain, Bind 20, 97, 2019.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - New diagnostic criteria for headache attributed to transient ischemic attacks
AU - Lebedeva, Elena R
AU - Gurary, Natalia M
AU - Olesen, Jes
PY - 2019
Y1 - 2019
N2 - BACKGROUND: The International Classification of Headache Disorders diagnostic criteria for Headache Attributed to Transient Ischemic Attack (TIA) and many other secondary headaches are based primarily on the opinion of experts. The aim of this study was to field test, for the first time, the diagnostic criteria for headache attributed to TIA of the International Classification of Headache Disorders, 3rd edition (ICHD-3) and in case of their weaknesses to propose new diagnostic criteria.METHODS: Consecutive patients with Transient Ischemic Attack and a simultaneous control group were extensively interviewed soon after admission. Data were collected on previous headaches, headaches around the time of Transient Ischemic Attack and characteristics of the TIA using validated neurologist conducted semi-structured interview forms. The evidence of relevant infarction were excluded in patients with Transient Ischemic Attack using magnetic resonance imaging with diffusion-weighted imaging (n = 112) or computed tomography (n = 8).RESULTS: One hundred twenty patients with Transient Ischemic Attack and 192 controls were included. A new type of headache occurred within 24 h in 16 (13%) of patients with Transient Ischemic Attack and in no controls, a preexisting type of headache with altered characteristics occurred in 9 (7.5%) of patients with Transient Ischemic Attack and no in controls, headache without altered characteristics occurred in 8 (6.6%) of patients with Transient Ischemic Attack and in 9 (4.6%) controls. Only 24% of the headaches in patients with Transient Ischemic Attack (8 of 33 patients) fulfilled the diagnostic criteria of International Classification of Headache Disorders-3 and no control patients. We propose new criteria fulfilled by 94% of the headaches. Specificity remained excellent as only one of 192 controls had a headache fulfilling the proposed criterion C.CONCLUSIONS: Existing diagnostic criteria for headache attributed to TIA of the International Classification of Headache Disorders are too insensitive. We suggest new diagnostic criteria with high sensitivity and preserved specificity.
AB - BACKGROUND: The International Classification of Headache Disorders diagnostic criteria for Headache Attributed to Transient Ischemic Attack (TIA) and many other secondary headaches are based primarily on the opinion of experts. The aim of this study was to field test, for the first time, the diagnostic criteria for headache attributed to TIA of the International Classification of Headache Disorders, 3rd edition (ICHD-3) and in case of their weaknesses to propose new diagnostic criteria.METHODS: Consecutive patients with Transient Ischemic Attack and a simultaneous control group were extensively interviewed soon after admission. Data were collected on previous headaches, headaches around the time of Transient Ischemic Attack and characteristics of the TIA using validated neurologist conducted semi-structured interview forms. The evidence of relevant infarction were excluded in patients with Transient Ischemic Attack using magnetic resonance imaging with diffusion-weighted imaging (n = 112) or computed tomography (n = 8).RESULTS: One hundred twenty patients with Transient Ischemic Attack and 192 controls were included. A new type of headache occurred within 24 h in 16 (13%) of patients with Transient Ischemic Attack and in no controls, a preexisting type of headache with altered characteristics occurred in 9 (7.5%) of patients with Transient Ischemic Attack and no in controls, headache without altered characteristics occurred in 8 (6.6%) of patients with Transient Ischemic Attack and in 9 (4.6%) controls. Only 24% of the headaches in patients with Transient Ischemic Attack (8 of 33 patients) fulfilled the diagnostic criteria of International Classification of Headache Disorders-3 and no control patients. We propose new criteria fulfilled by 94% of the headaches. Specificity remained excellent as only one of 192 controls had a headache fulfilling the proposed criterion C.CONCLUSIONS: Existing diagnostic criteria for headache attributed to TIA of the International Classification of Headache Disorders are too insensitive. We suggest new diagnostic criteria with high sensitivity and preserved specificity.
KW - Diffusion Magnetic Resonance Imaging/methods
KW - Female
KW - Headache/diagnostic imaging
KW - Humans
KW - Ischemic Attack, Transient/complications
KW - Magnetic Resonance Imaging/methods
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Tomography, X-Ray Computed/methods
U2 - 10.1186/s10194-019-1041-9
DO - 10.1186/s10194-019-1041-9
M3 - Journal article
C2 - 31492115
VL - 20
JO - Journal of Headache and Pain
JF - Journal of Headache and Pain
SN - 1129-2369
M1 - 97
ER -
ID: 236172150