Mark Odron¹ *, Ying-Tzu Lin ² , Yatharth Mahajan ³ and Peter G Bernad ¹,^4-7

¹ Division of Clinical Neurology Research, Neurology Services Inc., Washington DC, USA
²Poznań University of Medical Sciences, Poznań, Poland
³ Palm Desert High School, Palm Desert, CA, USA
⁴ Inova Fairfax Hospital, Fairfax County, VA, USA
⁵Inova Mount Vernon Hospital, Alexandria, VA, USA
⁶ George Washington University Hospital, Washington DC, USA
⁷American Medical International Quality Training, Washington DC, USA

*Corresponding Author: Mark Odron, Division of Clinical Neurology Research, Neurology Services Inc., Washington DC, USA.

Received: March 06, 2026; Published: March 31, 2026

Abstract

Headaches are among the most prevalent neurologic conditions worldwide, and are a frequent reason for neuroimaging, particularly when accompanied by clinical features that raise concern for secondary etiologies. In patients with established primary headache disorders and normal neurologic examination, the diagnostic yield of routine neuroimaging is low. Modern clinical evidence supports a selective, risk-stratified approach to neuroimaging, rather than indiscriminate imaging. This mini-review evaluates the diagnostic yield and clinical utility of neuroimaging to screen for secondary causes in patients with established primary headache disorders without focal neurologic deficits, seizures, and other red flag features. Current evidence demonstrates very low prevalence of clinically significant intracranial pathology in those diagnosed with a primary headache disorder and who underwent neuroimaging. Professional societies do not recommend routine neuroimaging in the absence of concerning clinical features. To this end, validated clinical frameworks, including the SNNOOP10 mnemonic, provide structured guidance for identifying patients at higher risk of secondary headache etiologies who may benefit from neuroimaging. The decision to perform imaging studies should remain symptom-guided and individualized, in order to balance diagnostic benefit against potential harms such as patient anxiety, unnecessary testing, and financial burden.

Keywords: Primary Headache; Neuroimaging; Magnetic Resonance Imaging (MRI)

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Citation

Citation: Mark Odron., et al. “Appropriateness of Neuroimaging to Screen for Secondary Causes in Patients with Established Primary Headache: A Mini-Review". Acta Scientific Neurology 9.4 (2026): 12-16.

Copyright

Copyright: ©2026 Mark Odron., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.