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June 2007

Trigeminal Autonomic Cephalgias: Is Neuroimaging Always Indicated?

Arch Neurol. 2007;64(6):917. doi:10.1001/archneur.64.6.917

We read with great interest the excellent review of trigeminal autonomic cephalgias (TAC) due to structural lesions reported by Favier et al.1 A main concern in the management of patients with TAC is when to perform neuroimaging studies because secondary causes may appear in 3% to 5% of cases.2 If a patient presents with typical TAC at a normal examination and the response to treatment is favorable, further diagnostic studies are probably not warranted. However, the clinician should be alert to atypical signs and symptoms, which should lead to appropriate testing.3

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