COINCIDENTAL FINDINGS OF PARA NASAL SINUS PATHOLOGY IN PATIENT REQUESTED BRAIN MAGNETIC RESONANCE IMAGING FOR HEADACHE

Abstract

Background  Headache is a ubiquitous symptom, for which magnetic resonance imaging (MRI) is the primary modality of choice to investigate its underlying causes. Two categories of headache have been well known” primary versus secondary types. Sinus pathology, including sinusitis, is a well-recognized cause of secondary headaches. Objectives  A retrospective study was conducted to find the incidence of sinus abnormalities in brain MRI patients presenting with headaches, compare the prevalence of sinus abnormalities versus other structural brain abnormalities at the brain MRI, and categorize the sinus abnormalities into significant and non-significant sinus involvement. In which significant sinus abnormalities might be the cause of headaches. Methods A retrospective study at the Sulaymaniyah teaching hospital selected data from brain MRIs of patients with headaches clinically, which were documented on their request paper. First, a Sum of 402 patients (males 157 and females 245) of age (mean age of 40 years) were included in the study from 2021-2022. Patients were grouped according to their imaging findings and specifically sinus abnormality. All statistical analyses were performed on a personal computer with SPSS for Windows (version 27) software. Results Four hundred and two cases during 12 months were reviewed; two hundred forty-five patients (60.9%) were female, and one hundred fifty-seven patients (39.1%) were male. Their ages varied from 14 years to 86 years. Approximately 50% of all patients are between the ages of 31 and 50. Sinus abnormalities were the most frequent group (40%), including significant sinus abnormalities of (19,9%), followed by normal brain MR findings (27.8%).  Conclusion The majority of patients suffering from headaches have sinus abnormalities on the brain MRI, in which near half of these abnormalities were significant findings, and the second most common imaging findings were normal brain imaging, which was more than the significant sinus abnormalities from here it is advisable for a better revision for the indication of brain MRI in headache, and as a consequence multidisciplinary evaluation of patients with headache should be introduced at an early stage. The team should include a headache specialist and a rhinologist to avoid unnecessary investigations. The significant sinus findings contribute to a substantial number of patients suffering from headaches, thus suggesting the inclusion of sinus findings as a regular part of the radiological reporting template.