# Prevalence of Sinus Mucosal Abnormalities on CT of the Head Performed for Headache When Compared With Those Performed for Other Indications

## TL;DR

This study found no significant difference in sinus issues on CT scans for headaches versus other reasons, but radiologists comment more on sinuses when headaches are the reason.

## Contribution

The study compares sinus abnormalities in CT scans for headaches versus other reasons and highlights radiologists' commenting patterns.

## Key findings

- No significant difference in clinically important sinus abnormalities between headache and non-headache groups.
- Radiologists commented on sinuses more frequently in the headache group.
- Corrected LM scores showed no significant difference between the two groups.

## Abstract

Background

There is a high prevalence of mucosal abnormalities of paranasal sinuses on CT Head scans performed for all indications. The purpose of this study is to see whether or not such abnormalities are more common in scans performed on patients presenting with headaches when compared with those without headaches.

Methods

Images of CT scans of the brain of 100 consecutive patients from each of the two study groups (a total of 200 scans) were retrospectively reviewed for the presence of sinus mucosal abnormalities and their Lund-Mackay (LM) scores were calculated. A corrected LM score was also calculated using a correction factor for non-visualized sinuses in some scans and osteomeatal complexes in all scans. Radiological reports for these scans were also reviewed to note whether or not they contained any comments on the sinuses. All the reviewed scans were performed between January 1, 2021 and January 22, 2021.

Results

In the headache group, 17 patients had an LM score above 4 (which was used as the main cut-off point for this study). In the non-headache group, 16 patients had a score greater than 4. The mean LM score in the headache group was 1.24 and in the non-headache group was 1.4. There has been no significant difference in the comparison when corrected LM scores were used. In the headache group, 22 radiology reports contained comments on the sinuses compared to 11 reports in the non-headache group.

Conclusion

Results of this study indicate that there is no significant difference in the prevalence of clinically important sinus mucosal abnormalities in patients who had a brain CT for headache when compared with other indications. It was found that radiologists tend to comment on the sinuses more often when the indication was headache. It may be reasonable for radiologists to consider reviewing this practice. This might reduce unnecessary referrals to ENT and, more importantly, avoid missing other reasons for headaches.