The Choosing Wisely RI campaign promotes productive conversations between patients and doctor--conversations that research shows produce the right level of care and go a long way towards eliminating tests, procedures and medications that provide, little, if any benefit. The campaign is organized and promoted by the Rhode Island Business Group on Health (RIBGH) and draws on the expertise of the American Board of Internal Medicine Foundation. While we provide materials that enable patients to have informed conversations with their doctors and other health care providers, we do not provide any individual medical advice.
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Imaging Tests for Headaches
When you need a CT scan or MRI—and when you don’t
CT scans and MRIs are called imaging tests because they take pictures, or images, of the inside of the body. Many people who have very painful headaches want a CT scan or an MRI. They want to find out if their headaches are caused by a serious problem, such as a brain tumor. But most of the time you don’t need these tests. Here’s why:
Imaging tests rarely help.
Doctors see many patients for headaches. And most of them have migraines or headaches caused by tension. Both kinds of headaches can be very painful. But a CT scan or an MRI rarely shows why the headache occurs. And they do not help you ease the pain.
According to the American College of Radiology, a doctor can diagnose most headaches during an office visit. The doctor asks you questions about your health and your symptoms. This is called a medical history. Then the doctor does a test of your reflexes, called a neurological exam. If your medical history and exam are normal, imaging tests usually will not show a serious problem.
CT scans have risks.
A CT scan of the head uses a low radiation dose. This may slightly increase the risk of harmful effects. Risks from radiation exposure may add up, so it is best to avoid unnecessary radiation. The results of your test may also be unclear. This can lead to more tests and even treatment that you do not need.
Imaging tests cost money.
The cost of a CT scan or MRI ranges from about $500 to more than $1,000. This depends on the test and where it’s done. Costs of a scan may be higher if the results are unclear and your doctor orders more tests or treatment.
When should you have an imaging test for headaches?
In some cases you might need a CT scan or an MRI. You might need one if your doctor cannot diagnose your headache based on your exam and medical history. Or you might need one if the exam finds something that is not normal.
You may also need a CT scan or an MRI if you have unusual headaches. See your doctor right away if:
This report is for you to use when talking with your health-care provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.Click here to download a PDF of these recommendations.