Erhan BAYRAM, Uluç YİŞ, Cem PAKETÇİ, Derya OKUR, İpek POLAT, Handan ÇAKMAKÇI, Semra HIZ, Banu ANLAR

Changes of primary headache related white matter lesions in pediatric patients

We aimed to describe the long-term prognosis of white matter lesions detectedon magnetic resonance imaging in children with primary headache. Childrenwho were admitted with the complaint of headache and had nonspecific whitematter lesions on magnetic resonance imaging were included in the study. Theclinical findings of the patients were reinvestigated using the same magneticresonance imaging scanner and acquisition protocol after at least a two yearperiod. Magnetic resonance imaging results of the patients were documentedin detail. Findings of the baseline and follow-up studies were compared witheach other by the same radiologist. Among the 11 patients, 8 ( 72.7%) weremale and 3 (27.3%) were female. Mean age of patients at the time of secondimaging was 12.9±2.3 years. Eight (72.7%) had migraine without aura, 1 (9.1%)had tension-type headache and 2 (18.2%) had migraine with aura. The meanclinical follow-up period of the patients was 4.31±1.31 years. All patients hadlow headache frequency on the last control visit when compared to the firstclinical findings. The follow-up magnetic resonance imaging studies showedtwo newly developed white matter lesions in two patients who had migrainewithout aura and the white matter lesions disappeared in the patient who hadtension-type headache, compared to the baseline neuroimaging. Findings ofthe baseline and long-term follow-up magnetic resonance imaging studies ofthe patients with primary headache showed no significant changes in termsof the location, size and laterality. Repeated neuro-imaging studies are notwarranted in the absence of the progression in clinical findings.

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