skip to main content
RadInfo Logo

Headache

Headaches are common, and most do not require imaging. However, imaging tests are important for headaches that have concerning features.

For adults with sudden-onset severe headache (“thunderclap headache”) that reaches maximal severity within 1 hour, CT head without intravenous (IV) contrast is usually appropriate.

For adults with primary migraines or tension-type headaches and a normal neurologic examination, imaging is usually not appropriate.

For adults with cluster headaches, MRI head without and with IV contrast is usually appropriate.

For adults with headaches likely caused by high pressure around the brain, MRI head without and with contrast, MRI head without contrast, and CT head without contrast are usually appropriate. For adults with headaches likely caused by low pressure around the brain, MRI head without and with contrast is usually appropriate.

For adults with headaches with new onset or pattern during or after pregnancy, MRI head without contrast and CT head without contrast are usually appropriate.

MRI head without and with contrast, MRI head without contrast, and CT head without contrast are usually appropriate for adults with headaches with one of more of the following “red flags”: increasing frequency or severity, fever or neurologic symptoms, history of cancer or of immunocompromise, older age (>50 years) at time of onset, or onset after trauma. For adults with headaches without any of these “red flags” and who do not have sudden-onset (thunderclap) headache, symptoms of low or high brain pressure, or new onset or headache pattern during or after pregnancy, imaging is usually not appropriate.

For more information, see the Headache page.

— By Rachael Newman, BS, and Orit Ariel Glenn, MD. This information originally appeared in the Journal of the American College of Radiology.

This page was reviewed on January 24, 2024

Sponsored By

Please note

RadiologyInfo.org is not a medical facility. Please contact your physician with specific medical questions or for a referral to a radiologist or other physician. To locate a medical imaging or radiation oncology provider in your community, you can search the ACR-accredited facilities database.

This website does not provide cost information. The costs for specific medical imaging tests, treatments and procedures may vary by geographic region. Discuss the fees associated with your prescribed procedure with your doctor, the medical facility staff and/or your insurance provider to get a better understanding of the possible charges you will incur.

Web page review process: This Web page is reviewed regularly by a physician with expertise in the medical area presented and is further reviewed by committees from the Radiological Society of North America (RSNA) and the American College of Radiology (ACR), comprising physicians with expertise in several radiologic areas.

Outside links: For the convenience of our users, RadiologyInfo.org provides links to relevant websites. RadiologyInfo.org, RSNA and ACR are not responsible for the content contained on the web pages found at these links.