When to order CT/MRI for headache ACG

Published on 31 Aug 2022
Last Updated on 31 Aug 2022

This ACE Clinical Guideline (ACG) covers the use of CT/MRI brain for diagnostic investigation of headache, providing evidence-based recommendations on the role of CT/MRI brain for primary and secondary headaches.

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When to order CT/MRI for headache (August 2022) [PDF, 1.2 MB]

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ACG Recommendations

1. Patients with migraine or TTH, without red flags: CT is not indicated; MRI is not indicated.

2. Patients with cluster headache or other trigeminal autonomic cephalalgias, without red flags: CT may be indicated; MRI is indicated.

3. Patients with sudden, severe headache: CT is indicated; MRI may be indicated.

4. Patients with headache and cancer or infection (suspected or known): CT may be indicated; MRI is indicated.

5. Patients with post-traumatic headache: CT is indicated; MRI may be indicated.

6. Patients with new headache accompanied by red flags, or with worsening headache: CT may be indicated; MRI is indicated.