Headaches: Should I Have Imaging Tests to Find Out What's Causing My Headaches?
Headaches: Should I Have Imaging Tests to Find Out What's Causing My Headaches?Skip to the navigationYou may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Headaches: Should I Have Imaging Tests to Find Out What's Causing My Headaches?Get the factsYour options- Have a
CT scan or
MRI to look for the cause of your headaches.
- Don't have these imaging tests.
Key points to remember- In most cases, an imaging test won't tell you what's causing
your headaches.
- Even when headaches are very painful, it's rare
that they are caused by a serious medical problem.
- Your doctor may
order an imaging test to rule out uncommon but serious medical problems such as
a brain tumor, a blood clot, or an infection.
- Imaging tests won't help you manage your pain. And they may not
change the type of treatment you get for your headaches unless they find a
serious problem.
FAQs Most
people get headaches from time to time. Most headaches are not serious. But
they can be very painful, and you may get them often. - Cluster headaches can cause severe pain during cycles or "clusters" of headaches
that happen over a period of weeks to months.
- Migraine headaches can cause a throbbing pain that
usually starts on one side of your head. When you have one of these headaches,
you may also feel sick to your stomach; vomit; and notice that you're more
sensitive to light, noise, and certain smells.
- Tension headaches can cause a constant ache,
tightness, and pressure around your forehead, temples, or the back of your head
and neck. It may feel like your head is in a vise.
It's rare that a headache is caused by a serious medical
problem. Most people can treat their headaches with pain relievers
that they buy without a prescription, like acetaminophen (such as Tylenol) or
ibuprofen (such as Advil). But others may need a prescription for stronger pain medicine to help them feel
better. There are two imaging tests that can be
used to evaluate your headaches: - A
CT scan uses
X-rays to make detailed pictures of the inside of your
head. During the test, your body is positioned so that your head is inside the
CT scanner, which is a large doughnut-shaped machine. The test usually takes
only a few minutes.
- An
MRI is a test that uses a
magnet and radio waves to make detailed pictures of the inside of your head. It
gives more information than X-rays or a CT scan. During the test, you lie
inside a machine that has a strong magnet. The test usually takes 30 to 60
minutes.
Keep in mind that having an imaging test won't help you
manage your pain. And it may not change the type of treatment you get for your
headaches unless it finds a more serious problem. In most cases,
you won't need to have an imaging test to look for the cause of your headaches.
Doctors can usually make a diagnosis and recommend treatment based on your
symptoms and by doing a physical exam. Your doctor may order one of these tests
to rule out uncommon but serious medical problems such as a brain tumor, a
blood clot, an infection, or a bulge (called an
aneurysm) in the wall of a blood vessel in your brain.
But most headaches aren't caused by these more serious problems. When headaches are a sign of a more serious medical problem or a head
injury, you may have other symptoms along with your headache. You may vomit,
feel dizzy or weak, or have numbness and tingling. Or you may have problems
with your vision and coordination. The risks from having a CT scan or an MRI are small. During a
CT scan, you're briefly exposed to radiation. There is a small risk of developing cancer from exposure to the X-rays used in CT scans. The risk is higher in children, young adults, and people who have many radiation tests. But the benefits of the test results are usually greater than the risk of radiation from a CT scan. If you are concerned about this risk, talk to your doctor and confirm that the test is needed. If you're pregnant, a CT
scan is usually not a good choice, because there is a chance that the baby
might be harmed by the radiation. An MRI doesn't use radiation.
And there are no known harmful effects from the magnetic field used during the
scan. But the magnet is powerful and may affect certain medical devices such as
pacemakers and metal objects such as heart valves,
brain clips, and ear implants. Sometimes a dye
(contrast material) may be used during a CT scan or
MRI. This can make the blood vessels and certain types of tissue (such as
tumors) in your brain easier to see. There is a slight chance that you may have
an allergic reaction to the dye. But most reactions are mild and can be treated
with medicine. Your doctor may advise you to have an imaging test if: - You have sudden, severe pain, and it feels
like the worst headache you have ever had.
- Your headaches have gotten worse.
- You have other symptoms along with your headaches, such as
dizziness, weakness, vision changes, numbness, tingling, and problems
with coordination.
- You are over 50 years of age and your headaches are different from when you were younger.
- You have severe headaches that wake you up at night or in the
morning.
- Your headaches occur during or after exercise or sex, or
when you cough or sneeze.
Compare your options | |
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What is usually involved? |
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What are the benefits? |
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What are the risks and side effects? |
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Have an imaging test
Have an imaging test
- During a CT scan:
- You will lie very still on a table that moves slightly while
the scanner takes pictures. You may hear a click or buzz as the table and
scanner move.
- Your head may be held with a strap to help you lie
still, but your face won't be covered.
- A dye may be injected into
your vein to make certain types of tissue easier to see.
- During an MRI scan:
- You lie inside a special machine that has a strong
magnet.
- Your head, chest, and arms may be held with straps to help
you lie still. A coil may be placed over or wrapped around your
head.
- You may hear a fan and feel air moving. You may also hear
tapping or snapping noises as the MRI takes pictures.
- A dye may be
injected into your vein to make certain types of tissue easier to see.
- Imaging tests can rule out
a serious medical problem such as a brain tumor, a blood clot, an infection, or
an aneurysm.
- A normal test result can reassure you that nothing
serious is causing your headaches.
- You might
have an allergic reaction to a dye that may be used during the test.
- If you have a CT scan, you'll be exposed to a small amount of
radiation.
Don't have an imaging
test Don't have an imaging
test - You keep taking
medicines to manage your headaches.
- You keep avoiding the things that cause your headaches (triggers).
- You keep a headache diary. This can help you find a pattern to your headaches and see if treatment is working.
- You make other lifestyle changes to help prevent headaches (such as sleeping well or managing stress).
- If your symptoms
don't improve with medicine, you can decide later to have an imaging test to
look for the cause of your headaches.
- You avoid being exposed to
radiation or having a possible allergic reaction to a dye that may be used
during the test.
- You avoid the cost of an imaging test.
- Your
headaches might be caused by a serious medical problem that needs to be treated
right away, and you won't know it.
I started
having headaches a few months ago, seems like out of the blue. The pain is
usually on one side of my head, although it can spread to my whole head. Light
hurts my eyes, and sound and quick body movements make the headaches worse.
Sometimes I feel nauseous. The headaches go away in a few hours, but I feel
exhausted for several days after the pain stops. My doctor said the headaches
are probably migraines. She gave me some medicines to stop a migraine when it
starts. I am going to try the medicines for a while and keep a headache diary
to get a better idea of when my headaches occur and if there is anything (like
certain foods) that might be triggering my headaches. I don't think I need
imaging tests right now. Headache pain started waking me up in the
night a couple of months after I had a minor car accident. I didn't go to the
hospital after my accident because I felt fine. The headache pain is pretty
severe but doesn't stick around too long. Sometimes I feel tingling down my arm
when I get a headache, and one side of my face feels numb. My vision gets a
little blurry, too. I went to see my doctor, who recommended I have imaging
tests to make sure I didn't injure my brain during the accident. I think I'll
have the imaging tests to make sure nothing serious is causing my
headaches. A few hours after I went to sleep, I
started waking up with extremely painful headaches that affect only one side of
my head and face. My nose gets runny, and my eye waters and droops a little bit
on the same side of my face. It feels like someone is sticking a hot poker in
the side of my head. The headache pain usually stops in about 30 minutes, but
then another one starts in an hour or two. I visited my doctor, and he said
these are classic cluster headache symptoms. I think my dad had these
headaches, too. I'm going to try the medicines the doctor gave me to stop the
headaches and see what happens. My doctor and I discussed imaging tests, but
neither of us thinks they are necessary right now. Even if I had the tests, my
treatment wouldn't change. I had breast
cancer a few years ago, but it went into remission after a long period of
treatment. And all my follow-up tests have been cancer-free. I have been
feeling pretty good for a few years now, but recently I started having
headaches that make me really nauseous. I smell weird smells and sometimes I
feel really spacey. Because of my history with cancer, my doctor thinks I
should have imaging tests even though these may just be migraine headaches-I
had a few migraines earlier in my life. My blood work keeps coming back normal,
but I am really worried about what could be causing my headaches. I am going to
have imaging tests just for reassurance that the cancer has not
returned. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have an imaging test to find the cause of my headaches Reasons not to have an imaging test I'm worried that something serious might be causing my headaches. I'm not worried that something serious might be causing my headaches. More important Equally important More important I'm not afraid to get a shot if a special dye is needed for the test. I don't like getting shots. More important Equally important More important I'm not worried about how much an imaging test costs, because my insurance will pay for it. I don't have insurance, and I can't afford to pay for an imaging test myself. More important Equally important More important My other important reasons: My other important reasons: More important Equally important More important Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having an imaging test NOT having an imaging test Leaning toward Undecided Leaning toward What else do you need to make your decision?1.
How sure do you feel right now about your decision? Not sure at all Somewhat sure Very sure Your SummaryHere's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. Next stepsWhich way you're leaningHow sure you areYour commentsKey concepts that you understoodKey concepts that may need reviewCredits | Author | Healthwise Staff |
|---|
| Primary Medical Reviewer | Anne C. Poinier, MD - Internal Medicine |
|---|
| Primary Medical Reviewer | Adam Husney, MD - Family Medicine |
|---|
| Primary Medical Reviewer | Martin J. Gabica, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | Colin Chalk, MD, CM, FRCPC - Neurology |
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You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Headaches: Should I Have Imaging Tests to Find Out What's Causing My Headaches?Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. - Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the FactsYour options- Have a
CT scan or
MRI to look for the cause of your headaches.
- Don't have these imaging tests.
Key points to remember- In most cases, an imaging test won't tell you what's causing
your headaches.
- Even when headaches are very painful, it's rare
that they are caused by a serious medical problem.
- Your doctor may
order an imaging test to rule out uncommon but serious medical problems such as
a brain tumor, a blood clot, or an infection.
- Imaging tests won't help you manage your pain. And they may not
change the type of treatment you get for your headaches unless they find a
serious problem.
FAQs What are the different types of headaches?Most
people get headaches from time to time. Most headaches are not serious. But
they can be very painful, and you may get them often. - Cluster headaches can cause severe pain during cycles or "clusters" of headaches
that happen over a period of weeks to months.
- Migraine headaches can cause a throbbing pain that
usually starts on one side of your head. When you have one of these headaches,
you may also feel sick to your stomach; vomit; and notice that you're more
sensitive to light, noise, and certain smells.
- Tension headaches can cause a constant ache,
tightness, and pressure around your forehead, temples, or the back of your head
and neck. It may feel like your head is in a vise.
It's rare that a headache is caused by a serious medical
problem. Most people can treat their headaches with pain relievers
that they buy without a prescription, like acetaminophen (such as Tylenol) or
ibuprofen (such as Advil). But others may need a prescription for stronger pain medicine to help them feel
better. What types of imaging tests can be used to find out what's causing your headaches?There are two imaging tests that can be
used to evaluate your headaches: - A
CT scan uses
X-rays to make detailed pictures of the inside of your
head. During the test, your body is positioned so that your head is inside the
CT scanner, which is a large doughnut-shaped machine. The test usually takes
only a few minutes.
- An
MRI is a test that uses a
magnet and radio waves to make detailed pictures of the inside of your head. It
gives more information than X-rays or a CT scan. During the test, you lie
inside a machine that has a strong magnet. The test usually takes 30 to 60
minutes.
Keep in mind that having an imaging test won't help you
manage your pain. And it may not change the type of treatment you get for your
headaches unless it finds a more serious problem. In most cases,
you won't need to have an imaging test to look for the cause of your headaches.
Doctors can usually make a diagnosis and recommend treatment based on your
symptoms and by doing a physical exam. Your doctor may order one of these tests
to rule out uncommon but serious medical problems such as a brain tumor, a
blood clot, an infection, or a bulge (called an
aneurysm) in the wall of a blood vessel in your brain.
But most headaches aren't caused by these more serious problems. When headaches are a sign of a more serious medical problem or a head
injury, you may have other symptoms along with your headache. You may vomit,
feel dizzy or weak, or have numbness and tingling. Or you may have problems
with your vision and coordination. What are the risks from having an imaging test?The risks from having a CT scan or an MRI are small. During a
CT scan, you're briefly exposed to radiation. There is a small risk of developing cancer from exposure to the X-rays used in CT scans. The risk is higher in children, young adults, and people who have many radiation tests. But the benefits of the test results are usually greater than the risk of radiation from a CT scan. If you are concerned about this risk, talk to your doctor and confirm that the test is needed. If you're pregnant, a CT
scan is usually not a good choice, because there is a chance that the baby
might be harmed by the radiation. An MRI doesn't use radiation.
And there are no known harmful effects from the magnetic field used during the
scan. But the magnet is powerful and may affect certain medical devices such as
pacemakers and metal objects such as heart valves,
brain clips, and ear implants. Sometimes a dye
(contrast material) may be used during a CT scan or
MRI. This can make the blood vessels and certain types of tissue (such as
tumors) in your brain easier to see. There is a slight chance that you may have
an allergic reaction to the dye. But most reactions are mild and can be treated
with medicine. Why might your doctor recommend an imaging test?Your doctor may advise you to have an imaging test if: - You have sudden, severe pain, and it feels
like the worst headache you have ever had.
- Your headaches have gotten worse.
- You have other symptoms along with your headaches, such as
dizziness, weakness, vision changes, numbness, tingling, and problems
with coordination.
- You are over 50 years of age and your headaches are different from when you were younger.
- You have severe headaches that wake you up at night or in the
morning.
- Your headaches occur during or after exercise or sex, or
when you cough or sneeze.
2. Compare your options| | Have an imaging test
| Don't have an imaging
test |
|---|
| What is usually involved? | - During a CT scan:
- You will lie very still on a table that moves slightly while
the scanner takes pictures. You may hear a click or buzz as the table and
scanner move.
- Your head may be held with a strap to help you lie
still, but your face won't be covered.
- A dye may be injected into
your vein to make certain types of tissue easier to see.
- During an MRI scan:
- You lie inside a special machine that has a strong
magnet.
- Your head, chest, and arms may be held with straps to help
you lie still. A coil may be placed over or wrapped around your
head.
- You may hear a fan and feel air moving. You may also hear
tapping or snapping noises as the MRI takes pictures.
- A dye may be
injected into your vein to make certain types of tissue easier to see.
| - You keep taking
medicines to manage your headaches.
- You keep avoiding the things that cause your headaches (triggers).
- You keep a headache diary. This can help you find a pattern to your headaches and see if treatment is working.
- You make other lifestyle changes to help prevent headaches (such as sleeping well or managing stress).
|
|---|
| What are the benefits? | - Imaging tests can rule out
a serious medical problem such as a brain tumor, a blood clot, an infection, or
an aneurysm.
- A normal test result can reassure you that nothing
serious is causing your headaches.
| - If your symptoms
don't improve with medicine, you can decide later to have an imaging test to
look for the cause of your headaches.
- You avoid being exposed to
radiation or having a possible allergic reaction to a dye that may be used
during the test.
- You avoid the cost of an imaging test.
|
|---|
| What are the risks and side effects? | - You might
have an allergic reaction to a dye that may be used during the test.
- If you have a CT scan, you'll be exposed to a small amount of
radiation.
| - Your
headaches might be caused by a serious medical problem that needs to be treated
right away, and you won't know it.
|
|---|
Personal storiesPersonal stories about imaging tests for evaluating headaches
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I started having headaches a few months ago, seems like out of the blue. The pain is usually on one side of my head, although it can spread to my whole head. Light hurts my eyes, and sound and quick body movements make the headaches worse. Sometimes I feel nauseous. The headaches go away in a few hours, but I feel exhausted for several days after the pain stops. My doctor said the headaches are probably migraines. She gave me some medicines to stop a migraine when it starts. I am going to try the medicines for a while and keep a headache diary to get a better idea of when my headaches occur and if there is anything (like certain foods) that might be triggering my headaches. I don't think I need imaging tests right now." "Headache pain started waking me up in the night a couple of months after I had a minor car accident. I didn't go to the hospital after my accident because I felt fine. The headache pain is pretty severe but doesn't stick around too long. Sometimes I feel tingling down my arm when I get a headache, and one side of my face feels numb. My vision gets a little blurry, too. I went to see my doctor, who recommended I have imaging tests to make sure I didn't injure my brain during the accident. I think I'll have the imaging tests to make sure nothing serious is causing my headaches." "A few hours after I went to sleep, I started waking up with extremely painful headaches that affect only one side of my head and face. My nose gets runny, and my eye waters and droops a little bit on the same side of my face. It feels like someone is sticking a hot poker in the side of my head. The headache pain usually stops in about 30 minutes, but then another one starts in an hour or two. I visited my doctor, and he said these are classic cluster headache symptoms. I think my dad had these headaches, too. I'm going to try the medicines the doctor gave me to stop the headaches and see what happens. My doctor and I discussed imaging tests, but neither of us thinks they are necessary right now. Even if I had the tests, my treatment wouldn't change." "I had breast cancer a few years ago, but it went into remission after a long period of treatment. And all my follow-up tests have been cancer-free. I have been feeling pretty good for a few years now, but recently I started having headaches that make me really nauseous. I smell weird smells and sometimes I feel really spacey. Because of my history with cancer, my doctor thinks I should have imaging tests even though these may just be migraine headaches-I had a few migraines earlier in my life. My blood work keeps coming back normal, but I am really worried about what could be causing my headaches. I am going to have imaging tests just for reassurance that the cancer has not returned." 3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have an imaging test to find the cause of my headaches Reasons not to have an imaging test I'm worried that something serious might be causing my headaches. I'm not worried that something serious might be causing my headaches. More important Equally important More important I'm not afraid to get a shot if a special dye is needed for the test. I don't like getting shots. More important Equally important More important I'm not worried about how much an imaging test costs, because my insurance will pay for it. I don't have insurance, and I can't afford to pay for an imaging test myself. More important Equally important More important My other important reasons: My other important reasons: More important Equally important More important 4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having an imaging test NOT having an imaging test Leaning toward Undecided Leaning toward 5. What else do you need to make your decision?
Check the facts1.
Is it rare for a headache to be caused by a serious medical problem? That's right. Even when headaches are very painful, it's rare that they are caused by a serious medical problem. 2.
Can imaging tests rule out more serious problems such as a brain tumor? That's right. An imaging test can rule out uncommon but serious medical problems such as a brain tumor, a blood clot, or an infection. 3.
Can an imaging test manage headache pain? That's right. Imaging tests won't help you manage your pain. And they may not change the type of treatment you get for your headaches unless they find a serious problem. Decide what's next1.
Do you understand the options available to you? 2.
Are you clear about which benefits and side effects matter most to you? 3.
Do you have enough support and advice from others to make a choice? Certainty1.
How sure do you feel right now about your decision? Not sure at all Somewhat sure Very sure 2.
Check what you need to do before you make this decision. Credits | By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Anne C. Poinier, MD - Internal Medicine |
|---|
| Primary Medical Reviewer | Adam Husney, MD - Family Medicine |
|---|
| Primary Medical Reviewer | Martin J. Gabica, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | Colin Chalk, MD, CM, FRCPC - Neurology |
|---|
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.Current as of:
October 14, 2016 Last modified on: 8 September 2017
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