COST-EFFECTIVENESS OF COMPUTED-TOMOGRAPHY IN THE EVALUATION OF PATIENTS WITH HEADACHE

We report a retrospective study to determine the cost-effectiveness of cranial computed tomography in patients with headache without neurolo gical finding. Five hundred ninety-two neurologically normal patients wars examined between 1990 and 1993 for the complaint of headache. Exa mination results were reevaluated from written report and image archiv e systems. Results were divided into three groups. In group P-0, we in cluded patients with normal cranial computed tomography findings. In g roup P-1, patients showed some minor pathologies like ischemic or atro phic changes. These findings neither explained the reason for headache nor changed the clinical or therapeutic approach. The third group (P- 2) was to include patients with gross intracranial pathology like spac e-occupying lesions or bleeding. Five hundred forty-six of 592 patient s were in the P,group (92%), and the remaining 46 patients were in the P-1 group (8%). No patient was found to have serious intracranial pat hology detected by computed tomography. Cost of detection of a case wi th significant pathology was calculated. It is our opinion that comput ed tomography is an unrewarding technique in the evaluation of patient s with chronic headache whose neurological examinations are normal.