To the Editor: In their Rational Clinical Examination article, Mr Detsky and colleagues1 evaluated the usefulness of the history and physical examination to determine whether a patient has migraine or some other condition requiring neuroimaging for diagnosis. I agree that patients with migraine do not ordinarily require neuroimaging. However, it is also important to consider that neuroimaging will not always define the illness in patients with other serious types of headache.
Brenner S. Does This Patient Have a Migraine?. JAMA. 2007;297(1):42. doi:10.1001/jama.297.1.42-a