Abstract and Introduction
When MRI scans of the brain are obtained for evaluation of primary headaches in adults, incidental findings are commonly present. After a review of the prevalence of incidental findings and normal anatomical variants, 21 types are presented.
About 90% of all headaches are the primary type where MRI scans of the brain will not reveal any pathology responsible for headaches. MRI scans are frequently done for primary headaches for a variety of reasons including the following: secondary pathology; at the patient's or family's request; to reassure the patient, "our stubborn quest for diagnostic certainty;" faulty cognitive reasoning; the medical decision rule where it is better to impute disease than to risk overlooking it; busy practice conditions where tests are ordered as a shortcut; financial incentives; professional peer pressure where recommendations for routine and esoteric tests are expected as a demonstration of competence; and medicolegal concerns. Incidental findings are common, often revealing benign pathology which may cause concern of the patient. Normal anatomical variants are also common. Definitions may differ among investigators as some may classify normal anatomical variants as incidental findings while others may not.
Headache. 2017;57(5):780-791. © 2017 Blackwell Publishing