ROLE OF CT BRAIN IN EVALUATING HEADACHE WITH NEURO-OPHTHALMIC RED FLAGS: FOCUS ON PAPILLEDEMA, CRANIAL NERVE PALSIES, AND VISUAL LOSS

Abstract

This cross-sectional study was conducted at the Department of Neurology, Lady Reading Hospital, Peshawar, to examine CT brain findings in patients with headache and neuro-ophthalmic red flags. A total of 119 patients were enrolled based on specific inclusion and exclusion criteria, with a focus on demographics, health parameters, and CT brain findings Demographics and Health Characteristics: The study cohort comprised 72.27% patients aged 18-50 years and 58.82% males. The majority had a BMI greater than 27 (59.66%), with 54.62% reporting headache frequency of ≤3 per week. A significant proportion of patients had normal blood pressure (45.38%) and normal serum sugar levels (73.11%). The analysis also included smoking status, with 36.97% smoking regularly. CT Brain Findings: Among the CT scans, 71% were normal, while 29% showed abnormal findings. The abnormal CT findings included clinically significant findings such as mass lesions (20.7%), vascular abnormalities (20.7%), and intracranial pressure issues (17.2%). Incidental findings such as age-related changes and sinus disease were noted in 41.4% of abnormal scans. BMI was found to significantly correlate with CT findings, with patients having a BMI >27 showing a higher frequency of abnormal CT scans (p = 0.045). Stratification by Health Parameters: Stratification based on age, gender, headache frequency, blood pressure, and serum sugar levels did not yield statistically significant results (p-value > 0.05). However, BMI emerged as a key factor influencing CT brain findings. Specifically, patients with BMI >27 had a higher likelihood of abnormal CT findings, demonstrating a significant association (p = 0.045). Additionally, smoking, duration of headache, and blood pressure did not show significant effects on CT brain outcomes (p-values > 0.5). Conclusion: This study highlights BMI as a significant determinant in CT brain findings among patients with headache and neuro-ophthalmic red flags. Mass lesions, vascular abnormalities, and intracranial pressure issues were identified as key clinically significant findings in abnormal CT scans. Although age, gender, blood pressure, and serum sugar levels did not show a significant relationship with CT outcomes, BMI warrants further investigation. Future studies with larger cohorts and focused stratification are recommended to better understand the influence of BMI and other health factors on CT brain findings.

Keywords: Headache, computed tomography, normal findings.