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Response to Comment on “Is conventional brain MRI useful for the diagnosis of cluste headache in patients who meet ICHD-3 criteria? Experience in three hospitals in Spain”

Published:January 31, 2022DOI:https://doi.org/10.1016/j.jns.2022.120176
      We sincerely thank our colleague F. Haghdoost for highlighting the importance of our findings recently published in this Journal [
      • Pérez-Pereda S.
      • Madera J.
      • González-Quintanilla V.
      • Marzal Drake-Pérez M.
      • Espí C.N.
      • Serrano Munuera C.
      • et al.
      Is conventional brain MRI useful for the diagnosis of cluster headache in patients who meet ICDH-3 criteria? Experience in three hospitals in Spain.
      ] and those of Grangeon et al. [
      • Grangeon L.
      • O’Connor E.
      • Danno D.
      • Ngoc T.M.P.
      • Cheema S.
      • Tronvik E.
      • et al.
      Is pituitary MRI screeing necessary in cluster headache.
      ], which suggest that brain MRI is not useful in cluster headache (CH) patients meeting ICHD-3 criteria. In his letter, he mentions that there could be patients who might have been diagnosed as CH but that after their neuroimaging detecting some abnormal findings might have received another diagnosis and not labelled as CH in our documents. He is right this is one of the problems of this kind of retrospective studies, but we think that in our particular case this bias was not relevant as, as stated in the manuscript, we reviewed all the charts initially diagnosed clinically as CH in our hospitals and in fact, as pointed out by F. Haghdoost in his letter, there were some patients whose diagnoses changed after the findings of structural lesions in their MRI. The interesting point is that all these patients (retrospectively) did not meet ICDH-3 criteria. One further argument supporting our data is that the results were fully homogeneous in three different hospitals.
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      References

        • Pérez-Pereda S.
        • Madera J.
        • González-Quintanilla V.
        • Marzal Drake-Pérez M.
        • Espí C.N.
        • Serrano Munuera C.
        • et al.
        Is conventional brain MRI useful for the diagnosis of cluster headache in patients who meet ICDH-3 criteria? Experience in three hospitals in Spain.
        J. Neurol. Sci. 2022; 434120122
        • Grangeon L.
        • O’Connor E.
        • Danno D.
        • Ngoc T.M.P.
        • Cheema S.
        • Tronvik E.
        • et al.
        Is pituitary MRI screeing necessary in cluster headache.
        Cephalalgia. 2021; 41: 779-788