Fundoscopic findings in patients presenting with primary headache disorders.

  • Bilal Khan MTI-Lady Reading Hospital, Peshawar.
  • Khalid Khanzada MTI-Lady Reading Hospital, Peshawar.
  • Muhammad Usman Khan Govt Naseer Ullah Babar Hospital, Peshawar.
  • Sajjad Ullah MTI-Lady Reading Hospital, Peshawar.
  • Usman Haqqani MTI-Lady Reading Hospital, Peshawar.
Keywords: Fundoscopy, Imaging, Neurosurgery, Out Patient Department (OPD), Primary Headache, Pappiledema

Abstract

Objectives: To know about the findings on fundoscopic examination in patients complaining of primary headache presenting to the Neurosurgical Outpatient Department (OPD). Study Design: Cross sectional study. Setting: Neurosurgery unit of Govt. Naseer Ullah Babar Memorial Hospital, Kohat Road, Peshawar. Period: December 2016 to December 2017. Materials and Methods: All patients presenting to the Neurosurgical OPD with complaints of headache on whom a fundoscopy was done, were included in the study. The age, gender, duration of symptoms, findings on the fundoscopy, and the need for further studies i.e. CT brain, were noted on a proforma. Any positive findings on fundoscopy were further referred to and evaluated by an ophthalmologist under the slit lamp. All patients with history of recent trauma, focal neurological deficit, and those who had undergone brain imaging were excluded from the study. Consent was taken from all the patients. The data was analyzed by SPSS version 19, and was expressed in the form of tables and charts. Results: A total of 19,000 patients were evaluated in the Neuro-OPD during study period, and 1086 patients were having headache.  Majority of the patients were females with a number of 619 (56.99%), while 447(43.01%) were males. The male to female ratio was approaching 1.38:1. Age range was from 9 to 62 years and the mean age was 37 years. Duration of symptoms was from 20 days to 12 years with a mean duration of 9 months. Positive findings were noted in a minority of patients, 2.5% (n=28); including pappiledema, diabetic and hypertensive changes. Subsequent Brain imaging was done in 93(8.5%) patients, majority of them were on patients' request, and only 7 patients were having an intracranial lesion. Conclusion: A minority of patients with headache without any neurology had intracranial lesion. However, the importance of fundoscopy cannot be overruled, and should be performed in every patient with headache.

Author Biographies

Bilal Khan, MTI-Lady Reading Hospital, Peshawar.

MBBS, FCPS, FRCSEng (SN), FEBNS

Assistant Professor

Department of Neurosurgery

Khalid Khanzada, MTI-Lady Reading Hospital, Peshawar.

MBBS, FCPS

Assistant Professor

Department of Neurosurgery

 

Muhammad Usman Khan, Govt Naseer Ullah Babar Hospital, Peshawar.

MBBS, FCPS)

District Neurosurgeon

 

Sajjad Ullah, MTI-Lady Reading Hospital, Peshawar.

MBBS

Resident

Department of Neurosurgery

 

Usman Haqqani, MTI-Lady Reading Hospital, Peshawar.

MBBS

Resident

Department of Neurosurgery

 

Published
2019-10-10