Headache: Five Things Physicians and Patients Should Question

1. Neuroimaging Studies:  These scans rarely diagnose the problem, and can actually pose risks.
2. CT Scans:  MRI scans should almost always be used in place of CT scans, but both in rare cases.
3. Trigger Point Surgery:  Surgical deactivation of migraine trigger points doesn’t yet have enough research behind it.
4. Butalbital and Opioids:  Risk > Benefit
5. OTC Pain Meds:  Prolonged or frequent can make things worse.

Bonus: EEGs:  The American Academy of Neurology version of the list includes “Don’t perform electroencephalography (EEG) for headaches.“

This list (the first five items) was the result of surveys and recommendations discussed through the AHS.  For more information from the Choosing Wisely initiative:

• American Headache Society: Five Things Physicians and Patients Should Question
• American Academy of Neurology: Five Things Physicians and Patients Should Question
• Consumer Reports Health: Imaging tests for headaches