We thank Wen and Shanti for their interest in and comments about our study.1 They describe their own observations and cite a recently published abstract2 that suggest that cerebral imaging procedures may have an appreciable yield for patients with chronic isolated headache. After comparing the data from the three sources (Wen and Shanti, the abstract,2 and our study1), however, we found that any differences could be explained by the different case definitions for chronic isolated headache that were used in each study. The reason that we found that slightly fewer patients with neurosurgical conditions presented with chronic isolated headache may be that our case definition for isolated headache was more precise and included only patients with chronic headache and the absence of (1) an abnormal neurologic examination, (2) neurologic symptoms, (3) persistent visual symptoms, (4) blurred vision, (5) personality changes, (6) cognitive deficit, (7) memory loss,
Weingarten S, Kleinman M, Elperin L, Larson E. Use of Cerebral Imaging in Patients With Headaches-Reply. Arch Intern Med. 1993;153(13):1613–1614. doi:10.1001/archinte.1993.00410130137016
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