REVIEW
Introdução: o uso de exames de imagem em pacientes com cefaleia é uma realidade nos serviços de saúde e parece ter aumentado apesar da disponibilidade de diretrizes clínicas práticas, critérios de adequação e parâmetros práticos para auxiliar no diagnóstico. Objetivo: analisar e gerar uma visão geral sobre a viabilidade do uso de exames de imagem em pacientes com queixas de cefaleia. Métodos: foi realizada uma busca nos bancos de dados PubMed, Medline, SciELO, Cochrane e Web of Science com os termos MeSH “headache”, “migraine”, “cluster”, “tension-type headache”, “tomography”, “magnetic resonance”, “diagnostic imaging” com o auxílio dos operadores booleanos OR e AND. Selecionamos 35 artigos que se relacionavam mais adequadamente com os objetivos deste trabalho, usando os critérios PRISMA. Resultados: estudos recentes destacaram a associação entre a COVID-19 e manifestações neurológicas, como acidente vascular cerebral, encefalite, confusão e dor de cabeça. Além disso, pesquisas sobre enxaqueca revelaram alterações estruturais no cérebro, como anormalidades na substância branca, lesões silenciosas semelhantes a infartos e alterações volumétricas, associadas à enxaqueca com aura. A espessura da íntima-média da artéria carótida também foi maior em pacientes com enxaqueca. Conclusão: são necessários mais estudos para aprofundar a compreensão dessas alterações e conscientizar os pacientes sobre o diagnóstico correto da enxaqueca.
Introduction: the use of imaging tests in patients with headache is a reality in health care and seems to have increased despite the availability of practical clinical guidelines, adequacy criteria and practical parameters to aid in diagnosis. Objective: to analyze and generate an overview about the feasibility of using imaging tests in patients with headache complaints. Methods: a search was carried out in PubMed, Medline, SciELO, Cochrane and Web of Science databases with the Mesh Terms “headache”, “migraine”, “cluster”, “tension-type headache”, “tomography”, “magnetic resonance”, “diagnostic imaging” with the aid of the Boolean operators OR and AND. We selected 35 articles that most adequately related to the objectives of this work, using the PRISMA criteria. Results: recent studies have highlighted the association between COVID-19 and neurological manifestations such as stroke, encephalitis, confusion, and headache. In addition, migraine research has revealed structural changes in the brain, such as white matter abnormalities, silent infarction-like lesions, and volumetric changes, associated with migraine with aura. Carotid artery intima-media thickness was also greater in patients with migraine. Conclusion: more studies are needed to deepen understanding of these changes and raise awareness among patients about the correct diagnosis of migraine.
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1Neurosurgery Department, Faculdade de Medicina, Universidade Atenas, Passos, MG, Brasil.
2Neurosurgery Department, Centro Universitário de Jaguariúna, Jaguariúna, SP, Brasil.
3Neurosurgery Department, Centro Universitário de Goiatuba – Unicerrado, Goiatuba, GO, Brasil.
Received Oct 2, 2023
Accepted May 23, 2024