Computerized Tomographic Scans for Headache-Reply

In Reply.— The research cited by Sargent and Lawson suggests that patients with migraine may experience permanent structural damage, a fact suggested and observed before the advent of CT.1-4We agree that use of CT in a research setting for systematic study of migraine may allow us to understand better this common illness where little is known about underlying pathological changes. As a research tool, CT is probably adequately cost-effective. However, our article discusses the use of CT for patients with headache, seen by clinicians who use CT to detect or confirm lesions that will affect subsequent patient treatment. Given the current understanding of migraine, we do not believe the findings described by Sargent, Lawson, and others alter patient treatment. Thus, we do not recommend its routine use in patients with normal findings from neurological examinations. Bohmfalk implies that he, as a neurosurgeon, is referred patients with mass lesions