Description
Brain (head) MRI is the procedure of choice for most brain disorders. It provides clear images of the brainstem and posterior brain, which are difficult to view on a CT scan. It is also useful for the diagnosis of demyelinating disorders (such as multiple sclerosis (MS) that cause destruction of the myelin sheath of the nerve). The evaluation of blood flow and the flow of cerebrospinal fluid (CSF) is possible with this non-invasive procedure.

MRI for headache — Generally, magnetic resonance imaging is the preferred imaging technique for evaluating the brain parenchyma, and CT is preferable for evaluating subarachnoid hemorrhage. CT is faster and more readily available than MRI and is often used in urgent clinical situations. Neurologic imaging is warranted in patients with headache disorders along with abnormal neurologic examination results or predisposing factors for brain pathology. Contrast-enhanced MRI is performed for evaluation of inflammatory, infectious, neoplastic, and demyelinating conditions.

Headache time frames and other characteristics — Generally, acute headaches are present from hours to days, subacute from days to weeks and chronic headaches for more than 3 months. Acute severe headaches are more likely to be pathological (e.g., SAH, cerebral venous thrombosis) than non-acute (e.g., migraine, tension-type). Headaches can also be categorized as new onset or chronic/recurrent. Non-acute new onset headaches do not require imaging unless there is a red flag as delineated above. Incidental findings lead to additional medical procedures and expense that do not improve patient well-being. Primary headache syndromes, such as migraine and tension headaches, are often episodic with persistent or progressive headache not responding to treatment requiring further investigation (e.g., new daily persistent headache). Imaging is indicated in chronic headaches if there is a change in the headache frequency (number of headaches episodes/month), duration of each episode, severity of the headaches or new characteristics, such as changing aura or associated symptoms.^{1,6,215,216,217}

Migraine with aura^6,7,218 — The headache phase of a migraine is preceded and/or accompanied by transient neurological symptoms referred to as aura in at least a third of migraine attacks. The most common aura consists of positive and/or negative visual phenomena, present in up to 99% of the individuals. Somatosensory is the secondary most common type of aura (mostly paresthesia’s in an upper limb and/or hemiface). Language/speech (mainly paraphasia and anomic aphasia) can also be affected. These neurological symptoms typically evolve over a period of minutes and may last up to 20 minutes or more. The gradual evolution of symptoms is thought to reflect spreading of a neurological event across the visual and somatosensory cortices. Characteristically, the aura usually precedes and terminates prior to headache, usually within 60 minutes. In others, it may persist or begin during the headache phase. ICHD-3 definition of the aura of migraine with typical aura consists of visual and/or sensory and/or speech/language symptoms, but no motor, brainstem or retinal symptoms and is characterized by gradual development, duration of each symptom no longer than one hour, a mix of positive and negative features and complete reversibility. Atypical or complex aura includes motor, brainstem, monocular visual disturbances, or ocular cranial nerve involvement (hemiplegic migraine, basilar migraine/brainstem aura, retinal migraine, ophthalmoplegic migraine) and secondary causes need to be excluded. Additional features of an aura that raise concern for an underlying vascular etiology include late age of onset, short duration, evolution of the focal symptoms, negative rather than positive visual phenomenon, and history of vascular risk factors.

Neurological deficits — Examples of abnormal reflexes related to upper motor neuron lesion/central pathology include hyperreflexia, clonus, Hoffman sign and Babinski, snout, palmar grasp, and rooting reflexes.

Visual loss has many possible etiologies, and MRI is only indicated in suspected neurological causes of visual loss based on history and exam. Visual field defects, such as bitemporal hemianopsia, homonymous hemianopsia, or quadranopsia, require imaging as well as does suspected optic nerve pathology. Subjective symptoms such as blurred vision or double vision with no clear correlate on neurological examination requires a comprehensive eye evaluation to exclude more common causes, such as cataracts, refractive errors, retinopathy, glaucoma, or macular degeneration. Transient visual loss with history consistent with TIA but normal exam at time of examination also should be imaged. Positive visual phenomena, such as photopsias or scintillations that march across the visual field, suggest migraine whereas negative phenomenon, such as shaded or blurred, is more characteristic of ischemia.
 
Table 1: Gait and brain imaging^{219,220,221,222,223,224}

Non-neurological causes of gait dysfunction include pain (antalgic), side effects of drugs (analgesic, antihistamines, benzos, psych meds, antihypertensives), visual loss, hearing impairment, orthopedic disorders, rheumatologic disorders, psychogenic, and cardiorespiratory problems (orthostasis).^{220,222,223,224}

MRI and recent stroke or transient ischemic attack — A stroke or central nervous system infarction is defined as “brain, spinal cord, or retinal cell death attributable to ischemia, based on neuropathological, neuroimaging, and/or clinical evidence of permanent injury. … Ischemic stroke specifically refers to central nervous system infarction accompanied by overt symptoms, whereas silent infarction causes no known symptoms.”²²⁵ If imaging or pathology is not available, a clinical stroke is diagnosed by symptoms persisting for more than 24 hours. Ischemic stroke can be further classified by the type and location of ischemia and the presumed etiology of the brain injury. These include large-artery atherosclerotic occlusion (extracranial or intracranial), cardiac embolism, small-vessel disease and less commonly dissection, hypercoagulable states, sickle cell disease and undetermined causes.²²⁶ TIAs in contrast, “are a brief episode of neurological dysfunction caused by focal brain or retinal ischemia, with clinical symptoms typically lasting less than one hour, and without evidence of acute infarction on imaging.”²²⁷ On average, the annual risk of future ischemic stroke after a TIA or initial ischemic stroke is 3% – 4%, with an incidence as high as 11% over the next 7 days and 24% – 29% over the following 5 years. This has significantly decreased in the last half century due to advances in secondary prevention.²²⁸

Therefore, when revascularization therapy is not indicated or available in individuals with an ischemic stroke or TIA, the focus of the work-up is on secondary prevention. This includes noninvasive vascular imaging to identify the underlying etiology, assess immediate complications and risk of future stroke. The majority of stroke evaluations take place in the inpatient setting. Admitting TIA patients is reasonable if they present within 72 hours and have an ABCD(2) score ≥ 3, indicating high risk of early recurrence, or the evaluation cannot be rapidly completed on an outpatient basis.²²⁷ Minimally, both stroke and TIA should have an evaluation for high-risk modifiable factors, such as carotid stenosis atrial fibrillation as the cause of ischemic symptoms.²²⁶ Diagnostic recommendations include neuroimaging evaluation as soon as possible, preferably with magnetic resonance imaging, including DWI; noninvasive imaging of the extracranial vessels should be performed, and noninvasive imaging of intracranial vessels is reasonable.²²⁹
Individuals with a history of stroke and recent work-up with new signs or symptoms indicating progression or complications of the initial CVA should have repeat brain imaging as an initial study. Individuals with remote or silent strokes discovered on imaging should be evaluated for high-risk modifiable risk factors based on the location and type of the presumed etiology of the brain injury.

Non-aneurysmal vascular malformations — Non-aneurysmal vascular malformations can be divided in low flow vascular malformations and high flow vascular malformations. Low flow vascular malformations include dural venous anomalies (DVA), cavernomas, and capillary telangiectasias. High flow vascular malformations include AVM and dural arteriovenous fistulas (dAVF). For low flow malformations, MRI is the study of choice. Limited medical literature is available to support vascular imagining (CTA or MRA). CTA plays a limited role in the assessment of cavernoma but may be used to demonstrate a DVA. MRA is not usually helpful in the assessment of cavernoma, capillary telangiectasia, and DVA. Vascular imaging is indicated in high flow vascular malformations.^230,231,232

MRI and central venous thrombosis — An MR venogram is indicated for the definite evaluation of a central venous thrombosis/dural sinus thrombosis. The most frequent presentations are isolated headache, intracranial hypertension syndrome (headache, nausea/vomiting, transient visual obscurations, pulsatile tinnitus, CN VI palsy, papilledema),²³³ seizures, focal neurological deficits, and encephalopathy. Risk factors are hypercoagulable states inducing genetic prothrombotic conditions, antiphospholipid syndrome and other acquired prothrombotic diseases (such as cancer), oral contraceptives, pregnancy, puerperium (6-weeks postpartum), infections, and trauma. COVID-19 infection is associated with hypercoagulability, a thromboinflammatory response, and an increased incidence of venous thromboembolic events (VTE).^234,235 Since venous thrombosis can cause SAH, infarctions, and hemorrhage, parenchymal imaging with MRI/CT is also appropriate.^27,236,237
 
Galactorrhea and MRI — Isolated galactorrhea without elevated prolactin (normoprolactinemic) is usually due to breast pathology, i.e., breast feeding, trauma, ill-fitting undergarments. Consider mammogram, breast ultrasound, and serial dilution of the individual’s prolactin sample to correct for possible hook effect.^238,239

Chart 1: Causes of Hyperprolactinemia²⁴⁰

Table 2: MRI and Staging Screening in Non-CNS Cancers^53,54,56,58

Surveillance for trilateral heritable retinoblastoma (Pineoblastoma surveillance)
Brain MRI at the time of retinoblastoma diagnosis; some centers recommend a brain MRI every 6 months until 5 years old^241,242

MRI and Neurocutaneous Syndromes

• In NF-1, clinical evaluation appears to be more useful to detect complications than is screening imaging in asymptomatic individuals. Imaging is indicated in evaluation of suspected tumors based on clinical evaluation and for follow-up of known intracranial tumors.²⁴³
• Conversely in NF-2, routine MR imaging screening is always indicated, given the high prevalence of CNS tumors, especially vestibular schwannomas. In individuals with NF-2, routine screening brain/IAC imaging is indicated annually starting from age 10 if asymptomatic or earlier with clinical signs/symptoms. Most individuals with NF2 eventually develop a spinal tumor, most commonly schwannomas, but meningioma and ependymomas are also seen. Spinal imaging at baseline and every 2 to 3 years is also advised with more frequent imaging, if warranted, based on sites of tumor involvement.⁶⁸
• In individuals with Tuberous Sclerosis, Brain MRI should be obtained every 1-3 years up until age 25 for surveillance for CNS abnormalities.⁶⁶
• In Von Hippel Lindau Syndrome, imaging of the brain and spinal cord for hemangioblastomas is recommended every 2 years.⁶⁵
• In Sturge Weber Syndrome, Brain MRI can rule out intracranial involvement only after age 1 and is recommended in individuals < 1 year only if symptomatic.⁶⁹

Multiple sclerosis^95,244,245 — The diagnosis of MS requires demonstration of lesions in the CNS disseminated in time and space and the absence of fever, infection, or other more likely etiologies. An expanding amount of available disease-modifying treatments are effective in slowing down disease progression, especially in the early stages. These treatments can have serious side effects and can be costly; therefore, the accurate and expeditious diagnosis of MS is critical.

The diagnosis of MS can be made on clinical presentation alone with 2 clinical attacks and objective clinical evidence of more than 2 lesions. Attacks may be individual-reported or objectively observed and must last for a minimum of 24 hours and be 30 days apart. However, corroborating magnetic resonance imaging (MRI) is the diagnostic standard and is used, as well, to rule out other disorders. Additionally, MRI findings can replace certain clinical criteria in a substantial number of individuals. In the revised McDonald Criteria, MRI findings can be used to establish dissemination in both time and space.

 
In the presence of a clear, clinically isolated syndrome such as optic neuritis, transverse myelitis, or brain stem syndrome, brain MRI is the next diagnostic step. MS can also have variable and often subjective symptoms that come and go (see Table 3). If there are recurrent episodes of variable neurological signs or symptoms not attributable to another cause with clinical concern for MS, imaging is warranted as well.

MRI and neuromyelitis optica spectrum disorders (NMOSD)²⁰³ — NMOSD are inflammatory disorders of the central nervous system characterized by severe, immune-mediated demyelination and axonal damage predominantly affecting the optic nerves and spinal cord, but also the brain and brainstem.

NMOSD can be distinguished from multiple sclerosis and other inflammatory disorders by the presence of the aquaporin-4 (AQP4) antibody. Features of NMOSD include attacks of bilateral or sequential optic neuritis acute transverse myelitis and the area postrema syndrome (with intractable hiccups or nausea and vomiting). The evaluation of suspected NMOSD entails brain and spinal cord neuroimaging. In contrast to MS (in which spinal cord involvement tends to be incomplete and asymmetric), NMOSD have a longer extent of spinal cord demyelination generally involving three or more vertebral segments.

Temporal arteritis — Giant cell arteritis (GCA) is an inflammatory disorder that should be considered in individuals over the age of 50 with the following signs or symptoms: new headaches, acute onset of visual disturbances (especially transient monocular visual loss), jaw claudication, constitutional symptoms, tenderness over the temporal artery, and elevated ESR and/or CRP. A diagnosis of polymyalgia rheumatica (PMR) is highly associated. Large vessel GCA denotes involvement of the aorta and its first-order branches, especially the subclavian arteries, and is common. Extra- and intracranial cerebral vasculitis can also be seen but is rarer, and strokes are related to vasculitis of extracranial cerebral arteries causing vertebral or internal carotid arteries stenosis. Gold standard for diagnosis of GCA is temporal artery biopsy. Color Doppler ultrasound (CDUS) can be used as a surrogate for temporal artery biopsy in some cases. High-resolution magnetic resonance imaging (MRI) can visualize the temporal arteries when used with contrast. The presence of clinical manifestations unusual in GCA should prompt consideration of alternative diagnoses. Examples of such include adenopathy, pulmonary infiltrates, digital cyanosis, ulceration or gangrene, mononeuritis multiplex, stroke in the distribution of the middle cerebral artery, glomerulitis, and/or rapidly rising creatinine.^{103,104,105,106,107,246}

MMSE — The Mini Mental State Examination (MMSE) is a tool that can be used to assess mental status systematically and thoroughly. It is an 11-question measure that tests five areas of cognitive function: orientation, registration, attention and calculation, recall, and language. The MMSE has been the most commonly used measure of cognitive function in dementia research, but researchers have recognized that it is relatively insensitive and variable in mildly impaired individuals. The maximum score is 30. A score of 23 or lower is indicative of cognitive impairment. The MMSE takes only 5 – 10 minutes to administer and is, therefore, practical to use repeatedly and routinely.

MoCA — The Montreal Cognitive Assessment (MoCA) was designed as a rapid screening instrument for mild cognitive dysfunction. It assesses different cognitive domains: attention and concentration, executive functions, memory, language, visuoconstructional skills, conceptual thinking, calculations, and orientation. MoCA differs from the MMSE mainly by including tests of executive function and abstraction, and by putting less weight on orientation to time and place. Ten of the MMSE's 30 points are scored solely on the time-place orientation test, whereas the MoCA assigns it a maximum of six points. The MoCA also puts more weight on recall and attention-calculation performance, while de- emphasizing language skill. Time to administer the MoCA is approximately 10 minutes. The total possible score is 30 points; a score of 26 or above is considered normal.

MRI and movement disorders — Atypical parkinsonian syndromes include progressive supranuclear palsy (PSP), multiple system atrophy (MSA), corticobasal degeneration (CBD), and dementia with Lewy bodies.

Anosmia — Nonstructural causes of anosmia include post-viral symptoms, medications (Amitriptyline, Enalapril, Nifedipine, Propranolol, Penicillamine, Sumatriptan, Cisplatin, Trifluoperazine, Propylthiouracil). These should be considered prior to advanced imaging to look for a structural cause.

Anosmia and dysgeusia have been reported as common early symptoms in individuals with COVID-19, occurring in greater than 80 percent of individuals. For isolated anosmia, imaging is typically not needed once the diagnosis of COVID has been made given the high association. As such, COVID testing should be done prior to imaging.^247,248,249

MRI orbits, face, and neck MRI rather than MRI brain is the mainstay for directly imaging the olfactory apparatus and sinonasal or anterior cranial fossa tumors that may impair or directly involve the olfactory apparatus.

Trigeminal neuralgia (TN) — According to the International Headache Society, TN is defined as “a disorder characterized by recurrent unilateral brief electric shock-like pain, abrupt in onset and termination, limited to the distribution of one or more divisions of the trigeminal nerve and triggered by innocuous stimuli.”⁶ Atypical features include bilateral, hearing loss, dizziness/vertigo, visual changes, sensory loss, numbness, pain > 2 min, pain outside trigeminal nerve distribution and progression.^140,214

Occipital neuralgia — According to the International Headache Society, occipital neuralgia is defined “Unilateral or bilateral paroxysmal, shooting or stabbing pain in the posterior part of the scalp, in the distribution(s) of the greater, lesser and/or third occipital nerves, sometimes accompanied by diminished sensation or dysesthesia in the affected area and commonly associated with tenderness over the involved nerve(s). Pain is eased temporarily by local anesthetic block of the affected nerve(s). Occipital neuralgia must be distinguished from occipital referral of pain arising from the atlantoaxial or upper zygapophyseal joints or from tender trigger points in neck muscles or their insertions.”⁶

MRI for macrocephaly — Consider ultrasound in infants with macrocephaly and a normal neurological examination, no evidence of increased ICP and an open anterior fontanelle. If head US is normal, the infant should be monitored closely.²⁵⁰ The anterior fontanelle generally closes between 10 and 24 months of age, with 3% closing between 5 – 9 months and 11% after 24 months.²⁵¹

MRI and normal pressure hydrocephalus (NPH) — Although diagnosis can be made based on CT findings alone, MRI is more accurate for disclosing associated pathologies (such as cerebrovascular disease), excluding other potential etiologies and for detecting NPH typical signs of prognostic value. A CT scan can exclude NPH and is appropriate for screening purposes and in individuals who cannot undergo MRI.¹⁵³

MRI and vertigo — The most common causes of vertigo seen are benign paroxysmal positional vertigo (BPPV), vestibular neuronitis (VN) and Ménière’s disease. These peripheral causes of vertigo are benign, and treatment involves reassurance and management of symptoms. Central causes of vertigo, such as cerebrovascular accidents (CVAs), tumors and multiple sclerosis (MS), need to be considered if the individual presents with associated neurological symptoms, such as weakness, diplopia, sensory changes, ataxia, or confusion. Magnetic resonance imaging is appropriate in the evaluation of individuals with vertigo who have neurologic signs and symptoms, progressive unilateral hearing loss or risk factors for cerebrovascular disease. MRI is more appropriate than CT for diagnosing vertigo due to its superiority in visualizing the posterior portion of the brain, where most central nervous system disease that causes vertigo is found. A full neurologic and otologic evaluation including provocative maneuvers, vestibular function testing and audiogram can help evaluate vertigo of unclear etiology and differentiate between central and peripheral vertigo.

MRI and developmental delay — Significant developmental delay is defined as significant delay (more than two standard deviations below the mean) in one or more developmental domains: gross/fine motor, speech/language, cognition, social/personal, and activities of daily living. Isolated delay in social/language development is characteristic of autism spectrum disorders or hearing loss. Isolated delay in motor development is characteristic of cerebral palsy (a static encephalopathy) or myopathy.
Global developmental delay (GDD) is a subset of developmental delay defined as significant delay (by at least 2 SD’s) in two or more developmental categories. Note that the term “GDD” is usually reserved for children < 5 years old, whereas in older children > 5 years, disability is quantifiable with IQ testing. The yield of magnetic resonance imaging is low in children with autism spectrum disorder and no other neurologic findings; therefore, MRI is not recommended as a part of routine evaluation.²⁵²

Low-risk brief resolved unexplained event (BRUE) formerly apparent life-threatening event (ALTE) requires all the following:

• Age > 60 days
• Gestational age ≥ 32 weeks or older and corrected gestational age > 45 weeks
• First brief event
• Event lasting < 1 minute
• No CPR required by the trained medical provider
• No concerning historical features or physical examination findings.

Combination MRI/MRA of the brain — This is one of the most misused combination studies and other than what is indicated above these examinations should be ordered in sequence, not together. Vascular abnormalities can be visualized on the brain MRI.

Individuals presenting with a new migraine with aura (especially an atypical or complex aura) can mimic a transient ischemic attack or an acute stroke. If there is a new neurologic deficit, imaging should be guided by concern for cerebrovascular disease, not that the individual has a headache.^11,197
 
Leptomeningeal carcinomatosis^{253,254,255,256} — Leptomeningeal metastasis is an uncommon and typically late complication of cancer with poor prognosis and limited treatment options. Diagnosis is often challenging with nonspecific presenting symptoms ranging from headache and confusion to focal neurologic deficits such as cranial nerve palsies. Standard diagnostic evaluation involves a neurologic examination, MRI of the brain and spine with gadolinium, and cytologic evaluation of the cerebral spinal fluid (CSF). Hematologic malignancies (leukemia and lymphoma), primary brain tumors as well as solid malignancies can spread to the leptomeninges. The most common solid tumors giving rise to LM are breast cancer (12% – 35%), small and non-small cell lung cancer (10% – 26 %), melanoma (5% – 25%), gastrointestinal malignancies (4% – 14%), and cancers of unknown primary (1% – 7%).

Drop metastases — Drop metastases are intradural extramedullary spinal metastases that arise from intracranial lesions. Common examples of intracranial neoplasms that result in drop metastases include pineal tumors, ependymomas, medulloblastomas, germinomas, primitive neuroectodermal tumors (PNET), glioblastomas multiform, anaplastic astrocytomas, oligodendrogliomas and less commonly choroid plexus neoplasms and teratomas.²⁵⁷

GENERAL INFORMATION

It is an expectation that all patients receive care/services from a licensed clinician. All appropriate supporting documentation, including recent pertinent office visit notes, laboratory data, and results of any special testing must be provided. If applicable: All prior relevant imaging results and the reason that alternative imaging cannot be performed must be included in the documentation submitted.

Where a specific clinical indication is not directly addressed in this guideline, medical necessity determination will be made based on widely accepted standard of care criteria. These criteria are supported by evidence-based or peer-reviewed sources such as medical literature, societal guidelines and state/national recommendations.
 

Policy 
INDICATIONS FOR BRAIN MRI
Brain MR/MRA are not approvable simultaneously unless they meet the criteria described below in the Indications for Brain MR/Brain MRA combination studies section. If there is a combination request* for an overlapping body part, either requested at the same time or sequentially (within the past 3 months) the results of the prior study should be:

• • • If atypical presentation (bilateral, absence of pain, optic nerve hemorrhages, severe visual impairment, lack of response to steroids, poor recovery or recurrence)^209,210
    • If needed to confirm optic neuritis and rule out compressive lesions
  • Known or suspected neuromyelitis optica spectrum disorder with severe, recurrent, or bilateral optic neuritis²⁰³
  • Suspected retinoblastoma^211,212
• Brain MRI/FACE/SINUS/NECK MRI
  • Granulomatosis with polyangiitis (Wegener’s granulomatosis) disease²¹³
  • Trigeminal neuralgia or neuropathy with an atypical presentation (for evaluation of the extracranial nerve course) ^140,214 See Background.
  • Bell’s Palsy/hemifacial spasm for evaluation of the extracranial nerve course -if atypical signs, slow resolution beyond three weeks, no improvement at four months, or facial twitching/spasms prior to onset¹³⁸
  • Objective cranial nerve palsy (CN IX-XII) (for evaluation of the extracranial nerve course)^140,141

References 

1. American College of Radiology. ACR Appropriateness Criteria® Headache. American College of Radiology. Updated 2022. Accessed January 23, 2023. https://acsearch.acr.org/docs/69482/Narrative/
2. Holle D, Obermann M. The role of neuroimaging in the diagnosis of headache disorders. Ther Adv Neurol Disord. Nov 2013;6(6):369-74. doi:10.1177/1756285613489765
3. Quinones-Hinojosa A, Gulati M, Singh V, Lawton MT. Spontaneous intracerebral hemorrhage due to coagulation disorders. Neurosurg Focus. Oct 15 2003;15(4):E3. doi:10.3171/foc.2003.15.4.3
4. Schaefer PW, Miller JC, Singhal AB, Thrall JH, Lee SI. Headache: when is neurologic imaging indicated? J Am Coll Radiol. Aug 2007;4(8):566-9. doi:10.1016/j.jacr.2006.10.001
5. Wilbrink LA, Ferrari MD, Kruit MC, Haan J. Neuroimaging in trigeminal autonomic cephalgias: when, how, and of what? Curr Opin Neurol. Jun 2009;22(3):247-53. doi:10.1097/wco.0b013e32832b4bb3
6. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. Jan 2018;38(1):1-211. doi:10.1177/0333102417738202
7. Micieli A, Kingston W. An Approach to Identifying Headache Patients That Require Neuroimaging. Front Public Health. 2019;7:52. doi:10.3389/fpubh.2019.00052
8. Mitsikostas DD, Ashina M, Craven A, et al. European Headache Federation consensus on technical investigation for primary headache disorders. J Headache Pain. 2015;17:5. doi:10.1186/s10194-016-0596-y
9. Hamilton K. Secondary Headaches During Pregnancy and the Postpartum Period. BMC. Updated May 2020. Accessed January 23, 2023. https://practicalneurology.com/articles/2020-may/secondary-headaches-during-pregnancy-and-the-postpartum-period
10. Shobeiri E, Torabinejad B. Brain magnetic resonance imaging findings in postpartum headache. Neuroradiol J. Feb 2019;32(1):4-9. doi:10.1177/1971400918804193
11. Nahas SJ. New Guidelines on Headache Imaging. NEJM Journal Watch. Updated January 8, 2020. Accessed January 23, 2023. https://www.jwatch.org/na50541/2020/01/08/new-guidelines-headache-imaging
12. D.W. D. Clinical clues and clinical rules: Primary vs secondary headache. Advanced Studies in Medicine. 2003;3(6C):S550-S555.
13. Togha M, Karimitafti MJ, Ghorbani Z, et al. Characteristics and comorbidities of headache in patients over 50 years of age: a cross-sectional study. BMC Geriatrics. 2022/04/10 2022;22(1):313. doi:10.1186/s12877-022-03027-1
14. Cordenier A, De Hertogh W, De Keyser J, Versijpt J. Headache associated with cough: a review. J Headache Pain. May 20 2013;14(1):42. doi:10.1186/1129-2377-14-42
15. Kuruvilla DE, Lipton RB. Appropriate use of neuroimaging in headache. Curr Pain Headache Rep. Jun 2015;19(6):17. doi:10.1007/s11916-015-0490-3
16. Martin VT. The diagnostic evaluation of secondary headache disorders. Headache. Feb 2011;51(2):346-52. doi:10.1111/j.1526-4610.2010.01841.x
17. Gofshteyn JS, Stephenson DJ. Diagnosis and Management of Childhood Headache. Curr Probl Pediatr Adolesc Health Care. Feb 2016;46(2):36-51. doi:10.1016/j.cppeds.2015.11.003

18. Dao JM, Qubty W. Headache Diagnosis in Children and Adolescents. Curr Pain Headache Rep. Feb 23 2018;22(3):17. doi:10.1007/s11916-018-0675-7
19. Trofimova A, Vey BL, Mullins ME, Wolf DS, Kadom N. Imaging of Children With Nontraumatic Headaches. AJR Am J Roentgenol. Jan 2018;210(1):8-17. doi:10.2214/ajr.17.18561
20. Wippold FJ, 2nd. Focal neurologic deficit. AJNR Am J Neuroradiol. Nov 2008;29(10):1998-2000.
21. American College of Radiology. ACR Appropriateness Criteria®Cerebrovascular Disease. American College of Radiology (ACR). Updated 2016. Accessed January 22, 2023. https://acsearch.acr.org/docs/69478/Narrative/
22. American College of Radiology. ACR Appropriateness Criteria®Cerebrovascular Disease-Child. American College of Radiology (ACR). Updated 2019. Accessed January 23, 2023. https://acsearch.acr.org/docs/3102253/Narrative/
23. Jauch EC, Saver JL, Adams HP, Jr., et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. Mar 2013;44(3):870-947. doi:10.1161/STR.0b013e318284056a
24. Akers A, Al-Shahi Salman R, I AA, et al. Synopsis of Guidelines for the Clinical Management of Cerebral Cavernous Malformations: Consensus Recommendations Based on Systematic Literature Review by the Angioma Alliance Scientific Advisory Board Clinical Experts Panel. Neurosurgery. May 1 2017;80(5):665-680. doi:10.1093/neuros/nyx091
25. Velz J, Stienen MN, Neidert MC, Yang Y, Regli L, Bozinov O. Routinely Performed Serial Follow-Up Imaging in Asymptomatic Patients With Multiple Cerebral Cavernous Malformations Has No Influence on Surgical Decision Making. Front Neurol. 2018;9:848. doi:10.3389/fneur.2018.00848
26. Zyck S, Gould GC. Cavernous Venous Malformation. StatPearls Publishing. Updated May 9, 2022. Accessed January 23, 2023. https://www.ncbi.nlm.nih.gov/books/NBK526009/
27. Bushnell C, Saposnik G. Evaluation and management of cerebral venous thrombosis. Continuum (Minneap Minn). Apr 2014;20(2 Cerebrovascular Disease):335-51. doi:10.1212/01.CON.0000446105.67173.a8
28. DeBaun MR, Jordan LC, King AA, et al. American Society of Hematology 2020 guidelines for sickle cell disease: prevention, diagnosis, and treatment of cerebrovascular disease in children and adults. Blood Adv. Apr 28 2020;4(8):1554-1588. doi:10.1182/bloodadvances.2019001142
29. Mackin RS, Insel P, Truran D, et al. Neuroimaging abnormalities in adults with sickle cell anemia: associations with cognition. Neurology. Mar 11 2014;82(10):835-41. doi:10.1212/wnl.0000000000000188
30. Thust SC, Burke C, Siddiqui A. Neuroimaging findings in sickle cell disease. Br J Radiol. Aug 2014;87(1040):20130699. doi:10.1259/bjr.20130699
31. Abboud MR, Cure J, Granger S, et al. Magnetic resonance angiography in children with sickle cell disease and abnormal transcranial Doppler ultrasonography findings enrolled in the STOP study. Blood. Apr 1 2004;103(7):2822-6. doi:10.1182/blood-2003-06-1972
32. Sheehan VA, Hansbury EN, Smeltzer MP, Fortner G, McCarville MB, Aygun B. Transcranial Doppler velocity and brain MRI/MRA changes in children with sickle cell anemia on chronic transfusions to prevent primary stroke. Pediatr Blood Cancer. Sep 2013;60(9):1499-502. doi:10.1002/pbc.24569
33. American College of Radiology. ACR Appropriateness Criteria® Head Trauma. American College of Radiology (ACR). Updated 2020. Accessed January 23, 2023. https://acsearch.acr.org/docs/69481/Narrative/
34. Jagoda AS, Bazarian JJ, Bruns JJ, Jr., et al. Clinical policy: neuroimaging and decisionmaking in adult mild traumatic brain injury in the acute setting. Ann Emerg Med. Dec 2008;52(6):714-48. doi:10.1016/j.annemergmed.2008.08.021
35. Polinder S, Cnossen MC, Real RGL, et al. A Multidimensional Approach to Post-concussion Symptoms in Mild Traumatic Brain Injury. Front Neurol. 2018;9:1113. doi:10.3389/fneur.2018.01113
36. Panwar J, Hsu CC, Tator CH, Mikulis D. Magnetic Resonance Imaging Criteria for Post-Concussion Syndrome: A Study of 127 Post-Concussion Syndrome Patients. J Neurotrauma. May 15 2020;37(10):1190-1196. doi:10.1089/neu.2019.6809
37. Kernick DP, Ahmed F, Bahra A, et al. Imaging patients with suspected brain tumour: guidance for primary care. Br J Gen Pract. Dec 2008;58(557):880-5. doi:10.3399/bjgp08X376203
38. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Central Nervous System Cancers Version 2.2022. National Comprehensive Cancer Network (NCCN). Updated September 29, 2022. Accessed January 23, 2023. https://www.nccn.org/professionals/physician_gls/pdf/cns.pdf
39. American College of Radiology. ACR Appropriateness Criteria® Neuroendocrine Imaging. American College of Radiology. Updated 2018. Accessed January 23, 2023. https://acsearch.acr.org/docs/69485/Narrative/
40. Consensus guidelines for the diagnosis and treatment of growth hormone (GH) deficiency in childhood and adolescence: summary statement of the GH Research Society. GH Research Society. J Clin Endocrinol Metab. Nov 2000;85(11):3990-3. doi:10.1210/jcem.85.11.6984
41. Kannan S, Kennedy L. Diagnosis of acromegaly: state of the art. Expert Opin Med Diagn. Sep 2013;7(5):443-53. doi:10.1517/17530059.2013.820181
42. Majumdar A, Mangal NS. Hyperprolactinemia. J Hum Reprod Sci. Jul 2013;6(3):168-75. doi:10.4103/0974-1208.121400
43. Bhasin S, Brito JP, Cunningham GR, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. May 1 2018;103(5):1715-1744. doi:10.1210/jc.2018-00229
44. Bonneville J-F, Potorac I, Petrossians P, Tshibanda L, Beckers A. Pituitary MRI in Cushing's disease - an update. Journal of Neuroendocrinology. 2022;34(8):e13123. doi:https://doi.org/10.1111/jne.13123
45. P. D, N.P. V. Dexamethasone Suppression Test. StatPearls Publishing Updated Aug 8 2022. Accessed April 7, 2023. https://www.ncbi.nlm.nih.gov/books/NBK542317/#_NBK542317_pubdet_
46. L.K. N. Recent Updates on the Diagnosis and Management of Cushing's Syndrome. Endocrinol Metab. 2018;33(2):139-146.
47. ARUP Consult aALtstfhp. Adrenal Hyperfunction (Cushing Syndrome) Testing Algorithm. ARUP Consult (https://arupconsult.com). Updated May 2021. Accessed April 7, 2023. https://arupconsult.com/algorithm/adrenal-hyperfunction-cushing-syndrome-testing-algorithm
48. Melmed S, Casanueva FF, Hoffman AR, et al. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. Feb 2011;96(2):273-88. doi:10.1210/jc.2010-1692
49. Casanueva FF, Molitch ME, Schlechte JA, et al. Guidelines of the Pituitary Society for the diagnosis and management of prolactinomas. Clin Endocrinol (Oxf). Aug 2006;65(2):265-73. doi:10.1111/j.1365-2265.2006.02562.x
50. Vilar L, Vilar CF, Lyra R, Freitas MDC. Pitfalls in the Diagnostic Evaluation of Hyperprolactinemia. Neuroendocrinology. 2019;109(1):7-19. doi:10.1159/000499694
51. Faizah M, Zuhanis A, Rahmah R, et al. Precocious puberty in children: A review of imaging findings. Biomed Imaging Interv J. Jan 2012;8(1):e6. doi:10.2349/biij.8.1.e6
52. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Kidney Cancer Version 4.2023. National Comprehensive Cancer Network (NCCN). Updated January 18, 2023. Accessed January 23, 2023. https://www.nccn.org/professionals/physician_gls/pdf/kidney.pdf
53. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Merkel Cell Carcinoma Version 2.2022. National Comprehensive Cancer Network (NCCN). Updated March 24, 2022. Accessed January 23, 2023. https://www.nccn.org/professionals/physician_gls/pdf/mcc.pdf
54. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Melanoma: Cutaneous Version 1.2023. National Comprehensive Cancer Network (NCCN). Updated December 22, 2022. Accessed January 23, 2023. https://www.nccn.org/professionals/physician_gls/pdf/cutaneous_melanoma.pdf
55. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Melanoma: Uveal Version 2.2022. National Comprehensive Cancer Network (NCCN). Updated April 5, 2022. Accessed January 23, 2023. https://www.nccn.org/professionals/physician_gls/pdf/uveal.pdf
56. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Non-Small Cell Lung Cancer Version 1.2023. National Comprehensive Cancer Network (NCCN). Updated December 22, 2022. Accessed January 23, 2023. https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf
57. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Neuroendocrine and Adrenal Tumors Version 2.2022. National Comprehensive Cancer Network (NCCN). Updated December 21, 2022. Accessed January 23, 2023. https://www.nccn.org/professionals/physician_gls/pdf/neuroendocrine.pdf
58. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Testicular Cancer Version 2.2022. National Comprehensive Cancer Network (NCCN). Updated January 4, 2022. Accessed January 23, 2023. https://www.nccn.org/professionals/physician_gls/pdf/testicular.pdf
59. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Bladder Cancer Version 3.2022. National Comprehensive Cancer Network (NCCN). Updated December 21, 2022. Accessed January 23, 2023. https://www.nccn.org/professionals/physician_gls/pdf/bladder.pdf
60. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Acute Myeloid Leukemia Version 3.2022. National Comprehensive Cancer Network (NCCN). Updated January 13, 2023. Accessed January 23, 2023. https://www.nccn.org/professionals/physician_gls/pdf/aml.pdf
61. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Gestational Trophoblastic Neoplasia Version 1.2023. National Comprehensive Cancer Network (NCCN). Updated December 20, 2022. Accessed January 23, 2023. https://www.nccn.org/professionals/physician_gls/pdf/gtn.pdf
62. Go RS, Jacobsen E, Baiocchi R, et al. Histiocytic Neoplasms, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. Nov 2021;19(11):1277-1303. doi:10.6004/jnccn.2021.0053

63. Goyal G, Young JR, Koster MJ, et al. The Mayo Clinic Histiocytosis Working Group Consensus Statement for the Diagnosis and Evaluation of Adult Patients With Histiocytic Neoplasms: Erdheim-Chester Disease, Langerhans Cell Histiocytosis, and Rosai-Dorfman Disease. Mayo Clin Proc. Oct 2019;94(10):2054-2071. doi:10.1016/j.mayocp.2019.02.023
64. Kumar P, Gill RM, Phelps A, Tulpule A, Matthay K, Nicolaides T. Surveillance Screening in Li-Fraumeni Syndrome: Raising Awareness of False Positives. Cureus. Apr 24 2018;10(4):e2527. doi:10.7759/cureus.2527
65. Rednam SP, Erez A, Druker H, et al. Von Hippel-Lindau and Hereditary Pheochromocytoma/Paraganglioma Syndromes: Clinical Features, Genetics, and Surveillance Recommendations in Childhood. Clin Cancer Res. Jun 15 2017;23(12):e68-e75. doi:10.1158/1078-0432.Ccr-17-0547
66. Krueger DA, Northrup H. Tuberous sclerosis complex surveillance and management: recommendations of the 2012 International Tuberous Sclerosis Complex Consensus Conference. Pediatr Neurol. Oct 2013;49(4):255-65. doi:10.1016/j.pediatrneurol.2013.08.002
67. Brandi ML, Gagel RF, Angeli A, et al. Guidelines for diagnosis and therapy of MEN type 1 and type 2. J Clin Endocrinol Metab. Dec 2001;86(12):5658-71. doi:10.1210/jcem.86.12.8070
68. Evans DGR, Salvador H, Chang VY, et al. Cancer and Central Nervous System Tumor Surveillance in Pediatric Neurofibromatosis 2 and Related Disorders. Clin Cancer Res. Jun 15 2017;23(12):e54-e61. doi:10.1158/1078-0432.Ccr-17-0590
69. Comi AM. Presentation, diagnosis, pathophysiology, and treatment of the neurological features of Sturge-Weber syndrome. Neurologist. Jul 2011;17(4):179-84. doi:10.1097/NRL.0b013e318220c5b6
70. Stoller JK, Nielsen C, Buccola J. Pituitary Tumor. Cleveland Clinic Intensive Review of Internal Medicine. 6th ed. Wolters Kluwer; 2015.
71. Eroukhmanoff J, Tejedor I, Potorac I, et al. MRI follow-up is unnecessary in patients with macroprolactinomas and long-term normal prolactin levels on dopamine agonist treatment. Eur J Endocrinol. Mar 2017;176(3):323-328. doi:10.1530/eje-16-0897
72. Kurosaki M, Kambe A, Watanabe T, Fujii S, Ogawa T. Serial 3 T magnetic resonance imaging during cabergoline treatment of macroprolactinomas. Neurol Res. Apr 2015;37(4):341-6. doi:10.1179/1743132814y.0000000457
73. Varlamov EV, Hinojosa-Amaya JM, Fleseriu M. Magnetic resonance imaging in the management of prolactinomas; a review of the evidence. Pituitary. Feb 2020;23(1):16-26. doi:10.1007/s11102-019-01001-6
74. Dekkers OM, Pereira AM, Romijn JA. Treatment and follow-up of clinically nonfunctioning pituitary macroadenomas. J Clin Endocrinol Metab. Oct 2008;93(10):3717-26. doi:10.1210/jc.2008-0643
75. Lake MG, Krook LS, Cruz SV. Pituitary adenomas: an overview. Am Fam Physician. Sep 1 2013;88(5):319-27.
76. Cauley KA, Linnell GJ, Braff SP, Filippi CG. Serial follow-up MRI of indeterminate cystic lesions of the pineal region: experience at a rural tertiary care referral center. AJR Am J Roentgenol. Aug 2009;193(2):533-7. doi:10.2214/ajr.08.1906
77. Jussila MP, Olsén P, Salokorpi N, Suo-Palosaari M. Follow-up of pineal cysts in children: is it necessary? Neuroradiology. Dec 2017;59(12):1265-1273. doi:10.1007/s00234-017-1926-8

78. Trifanescu R, Ansorge O, Wass JAH, Grossman AB, Karavitaki N. Rathke’s cleft cysts. Clinical Endocrinology. 2012;76(2):151-160. doi:https://doi.org/10.1111/j.1365-2265.2011.04235.x
79. Petersson M, Berinder K, Eden Engström B, et al. Natural history and surgical outcome of Rathke's cleft cysts—A study from the Swedish Pituitary Registry. Clinical Endocrinology. 2022;96(1):54-61. doi:https://doi.org/10.1111/cen.14622
80. Al-Holou WN, Yew AY, Boomsaad ZE, Garton HJ, Muraszko KM, Maher CO. Prevalence and natural history of arachnoid cysts in children. J Neurosurg Pediatr. Jun 2010;5(6):578-85. doi:10.3171/2010.2.Peds09464
81. Al-Holou WN, Terman S, Kilburg C, Garton HJ, Muraszko KM, Maher CO. Prevalence and natural history of arachnoid cysts in adults. J Neurosurg. Feb 2013;118(2):222-31. doi:10.3171/2012.10.Jns12548
82. Jafrani R, Raskin JS, Kaufman A, Lam S. Intracranial arachnoid cysts: Pediatric neurosurgery update. Surg Neurol Int. 2019;10:15. doi:10.4103/sni.sni_320_18
83. Mustansir F, Bashir S, Darbar A. Management of Arachnoid Cysts: A Comprehensive Review. Cureus. Apr 10 2018;10(4):e2458. doi:10.7759/cureus.2458
84. Haupt R, Minkov M, Astigarraga I, et al. Langerhans cell histiocytosis (LCH): guidelines for diagnosis, clinical work-up, and treatment for patients till the age of 18 years. Pediatr Blood Cancer. Feb 2013;60(2):175-84. doi:10.1002/pbc.24367
85. American College of Radiology. ACR Appropriateness Criteria® Seizures and Epilepsy. American College of Radiology. Updated 2019. Accessed January 23, 2023. https://acsearch.acr.org/docs/69479/Narrative/
86. Cendes F, Theodore WH, Brinkmann BH, Sulc V, Cascino GD. Neuroimaging of epilepsy. Handb Clin Neurol. 2016;136:985-1014. doi:10.1016/b978-0-444-53486-6.00051-x
87. Gaillard WD, Chiron C, Cross JH, et al. Guidelines for imaging infants and children with recent-onset epilepsy. Epilepsia. Sep 2009;50(9):2147-53. doi:10.1111/j.1528-1167.2009.02075.x
88. Ho K, Lawn N, Bynevelt M, Lee J, Dunne J. Neuroimaging of first-ever seizure: Contribution of MRI if CT is normal. Neurol Clin Pract. Oct 2013;3(5):398-403. doi:10.1212/CPJ.0b013e3182a78f25
89. Krumholz A, Wiebe S, Gronseth G, et al. Practice Parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology. Nov 20 2007;69(21):1996-2007. doi:10.1212/01.wnl.0000285084.93652.43
90. Ramli N, Rahmat K, Lim KS, Tan CT. Neuroimaging in refractory epilepsy. Current practice and evolving trends. Eur J Radiol. Sep 2015;84(9):1791-800. doi:10.1016/j.ejrad.2015.03.024
91. Hourani R, Nasreddine W, Dirani M, et al. When Should a Brain MRI Be Performed in Children with New-Onset Seizures? Results of a Large Prospective Trial. American Journal of Neuroradiology. 2021;42(9):1695-1701. doi:10.3174/ajnr.A7193
92. Hirtz D, Ashwal S, Berg A, et al. Practice parameter: evaluating a first nonfebrile seizure in children: report of the quality standards subcommittee of the American Academy of Neurology, The Child Neurology Society, and The American Epilepsy Society. Neurology. Sep 12 2000;55(5):616-23. doi:10.1212/wnl.55.5.616
93. Bernasconi A, Cendes F, Theodore WH, et al. Recommendations for the use of structural magnetic resonance imaging in the care of patients with epilepsy: A consensus report from the International League Against Epilepsy Neuroimaging Task Force. Epilepsia. Jun 2019;60(6):1054-1068. doi:10.1111/epi.15612
94. Consortium of Multiple Sclerosis Centers. 2018 MRI Protocol and Clinical Guidelines for MS. Consortium of Multiple Sclerosis Centers (CMSC). Updated May 22, 2018. Accessed January 23, 2023. https://www.mscare.org/page/MRI_protocol
95. Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. Feb 2018;17(2):162-173. doi:10.1016/s1474-4422(17)30470-2
96. Traboulsee A, Simon JH, Stone L, et al. Revised Recommendations of the Consortium of MS Centers Task Force for a Standardized MRI Protocol and Clinical Guidelines for the Diagnosis and Follow-Up of Multiple Sclerosis. AJNR Am J Neuroradiol. Mar 2016;37(3):394-401. doi:10.3174/ajnr.A4539
97. Wattjes MP, Ciccarelli O, Reich DS, et al. 2021 MAGNIMS-CMSC-NAIMS consensus recommendations on the use of MRI in patients with multiple sclerosis. Lancet Neurol. Aug 2021;20(8):653-670. doi:10.1016/s1474-4422(21)00095-8
98. Rae-Grant A, Day GS, Marrie RA, et al. Practice guideline recommendations summary: Disease-modifying therapies for adults with multiple sclerosis: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. Apr 24 2018;90(17):777-788. doi:10.1212/wnl.0000000000005347
99. Amato MP, De Stefano N, Inglese M, et al. Secondary Prevention in Radiologically Isolated Syndromes and Prodromal Stages of Multiple Sclerosis. Review. Frontiers in Neurology. 2022-March-14 2022;13doi:10.3389/fneur.2022.787160
100. McGuigan C, Craner M, Guadagno J, et al. Stratification and monitoring of natalizumab-associated progressive multifocal leukoencephalopathy risk: recommendations from an expert group. J Neurol Neurosurg Psychiatry. Feb 2016;87(2):117-25. doi:10.1136/jnnp-2015-311100
101. Lummel N, Koch M, Klein M, Pfister HW, Brückmann H, Linn J. Spectrum and Prevalence of Pathological Intracranial Magnetic Resonance Imaging Findings in Acute Bacterial Meningitis. Clin Neuroradiol. Jun 2016;26(2):159-67. doi:10.1007/s00062-014-0339-x
102. Oliveira CR, Morriss MC, Mistrot JG, Cantey JB, Doern CD, Sánchez PJ. Brain magnetic resonance imaging of infants with bacterial meningitis. J Pediatr. Jul 2014;165(1):134-9. doi:10.1016/j.jpeds.2014.02.061
103. Diamantopoulos AP, Haugeberg G, Hetland H, Soldal DM, Bie R, Myklebust G. Diagnostic value of color Doppler ultrasonography of temporal arteries and large vessels in giant cell arteritis: a consecutive case series. Arthritis Care Res (Hoboken). Jan 2014;66(1):113-9. doi:10.1002/acr.22178
104. D'Souza NM, Morgan ML, Almarzouqi SJ, Lee AG. Magnetic resonance imaging findings in giant cell arteritis. Eye (Lond). May 2016;30(5):758-62. doi:10.1038/eye.2016.19
105. Klink T, Geiger J, Both M, et al. Giant cell arteritis: diagnostic accuracy of MR imaging of superficial cranial arteries in initial diagnosis-results from a multicenter trial. Radiology. Dec 2014;273(3):844-52. doi:10.1148/radiol.14140056
106. Salehi-Abari I. 2016 ACR revised criteria for early diagnosis of giant cell (temporal) arteritis. Autoimmune Dis Ther Approaches Open Access. 2016;3:1-4.
107. Yip A, Jernberg ET, Bardi M, et al. Magnetic resonance imaging compared to ultrasonography in giant cell arteritis: a cross-sectional study. Arthritis Res Ther. Oct 19 2020;22(1):247. doi:10.1186/s13075-020-02335-4

108. Zuccoli G, Pipitone N, Haldipur A, Brown RD, Jr., Hunder G, Salvarani C. Imaging findings in primary central nervous system vasculitis. Clin Exp Rheumatol. Jan-Feb 2011;29(1 Suppl 64):S104-9.
109. Godasi R, Pang G, Chauhan S, Bollu PC. Primary Central Nervous System Vasculitis. StatPearls Publishing. Updated October 12, 2022. Accessed January 23, 2023. https://www.ncbi.nlm.nih.gov/books/NBK482476/
110. Voortman M, Drent M, Baughman RP. Management of neurosarcoidosis: a clinical challenge. Curr Opin Neurol. Jun 2019;32(3):475-483. doi:10.1097/wco.0000000000000684
111. Fritz D, van de Beek D, Brouwer MC. Clinical features, treatment and outcome in neurosarcoidosis: systematic review and meta-analysis. BMC Neurol. Nov 15 2016;16(1):220. doi:10.1186/s12883-016-0741-x
112. Shah R, Roberson GH, Curé JK. Correlation of MR imaging findings and clinical manifestations in neurosarcoidosis. AJNR Am J Neuroradiol. May 2009;30(5):953-61. doi:10.3174/ajnr.A1470
113. Harvey PD. Clinical applications of neuropsychological assessment. Dialogues Clin Neurosci. Mar 2012;14(1):91-9. doi:10.31887/DCNS.2012.14.1/pharvey
114. Health Quality Ontario. The appropriate use of neuroimaging in the diagnostic work-up of dementia: an evidence-based analysis. Ont Health Technol Assess Ser. 2014;14(1):1-64.
115. Narayanan L, Murray AD. What can imaging tell us about cognitive impairment and dementia? World J Radiol. Mar 28 2016;8(3):240-54. doi:10.4329/wjr.v8.i3.240
116. Carpenter CR, Bassett ER, Fischer GM, Shirshekan J, Galvin JE, Morris JC. Four sensitive screening tools to detect cognitive dysfunction in geriatric emergency department patients: brief Alzheimer's Screen, Short Blessed Test, Ottawa 3DY, and the caregiver-completed AD8. Acad Emerg Med. Apr 2011;18(4):374-84. doi:10.1111/j.1553-2712.2011.01040.x
117. McDougall GJ. A review of screening instruments for assessing cognition and mental status in older adults. Nurse Pract. Nov 1990;15(11):18-28.
118. U.S. Food & Drug Administration. Reference ID: 4807032 Full Prescribing Information ADUHELM(tm). U.S. Food & Drug Administration. Updated June 2021. Accessed January 23, 2023. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/761178s000lbl.pdf
119. Inc. B. Aduhelm™ [prescribing information] Biogen Inc. 2023. Updated February 2023. 2023. https://www.biogencdn.com/us/aduhelm-pi.pdf
120. American College of Radiology. ACR Appropriateness Criteria® Movement Disorders and Neurodegenerative Diseases. American College of Radiology. Updated 2019. Accessed January 23, 2023. https://acsearch.acr.org/docs/3111293/Narrative/
121. Albanese A, Asmus F, Bhatia KP, et al. EFNS guidelines on diagnosis and treatment of primary dystonias. Eur J Neurol. Jan 2011;18(1):5-18. doi:10.1111/j.1468-1331.2010.03042.x
122. Mascalchi M, Vella A, Ceravolo R. Movement disorders: role of imaging in diagnosis. J Magn Reson Imaging. Feb 2012;35(2):239-56. doi:10.1002/jmri.22825
123. McFarland NR. Diagnostic Approach to Atypical Parkinsonian Syndromes. Continuum (Minneap Minn). Aug 2016;22(4 Movement Disorders):1117-42. doi:10.1212/con.0000000000000348
124. Pyatigorskaya N, Gallea C, Garcia-Lorenzo D, Vidailhet M, Lehericy S. A review of the use of magnetic resonance imaging in Parkinson's disease. Ther Adv Neurol Disord. Jul 2014;7(4):206-20. doi:10.1177/1756285613511507

125. Sharifi S, Nederveen AJ, Booij J, van Rootselaar AF. Neuroimaging essentials in essential tremor: a systematic review. Neuroimage Clin. 2014;5:217-31. doi:10.1016/j.nicl.2014.05.003
126. Comella CL, National Organization for Rare Disorders. Cervical Dystonia. National Organization for Rare Disorders (NORD). Updated 2019. Accessed January 23, 2023. https://rarediseases.org/rare-diseases/cervical-dystonia/
127. Chang VA, Meyer DM, Meyer BC. Isolated Anisocoria as a Presenting Stroke Code Symptom is Unlikely to Result in Alteplase Administration. J Stroke Cerebrovasc Dis. Jan 2019;28(1):163-166. doi:10.1016/j.jstrokecerebrovasdis.2018.09.029
128. Iliescu DA, Timaru CM, Alexe N, et al. Management of diplopia. Rom J Ophthalmol. Jul-Sep 2017;61(3):166-170. doi:10.22336/rjo.2017.31
129. American Association for Pediatric Ophthalmology and Strabismus. Five things physicians and patients should question: Don’t routinely order neuro-imaging for all patients with double vision. Choosing Wisely Initiative ABIM Foundation. Updated May 29, 2019. Accessed January 23, 2023. https://www.choosingwisely.org/clinician-lists/american-association-pediatric-ophthalmology-strabismus-imaging-for-double-vision/
130. Kadom N. Pediatric strabismus imaging. Curr Opin Ophthalmol. Sep 2008;19(5):371-8. doi:10.1097/ICU.0b013e328309f165
131. Yoon L, Kim HY, Kwak MJ, et al. Utility of Magnetic Resonance Imaging (MRI) in Children With Strabismus. J Child Neurol. Sep 2019;34(10):574-581. doi:10.1177/0883073819846807
132. Lee JH, Lee HK, Lee DH, Choi CG, Kim SJ, Suh DC. Neuroimaging strategies for three types of Horner syndrome with emphasis on anatomic location. AJR Am J Roentgenol. Jan 2007;188(1):W74-81. doi:10.2214/ajr.05.1588
133. Bendtsen L, Zakrzewska JM, Abbott J, et al. European Academy of Neurology guideline on trigeminal neuralgia. Eur J Neurol. Jun 2019;26(6):831-849. doi:10.1111/ene.13950
134. Cruccu G, Finnerup NB, Jensen TS, et al. Trigeminal neuralgia: New classification and diagnostic grading for practice and research. Neurology. Jul 12 2016;87(2):220-8. doi:10.1212/wnl.0000000000002840
135. Garza I. Craniocervical junction schwannoma mimicking occipital neuralgia. Headache. Sep 2007;47(8):1204-5. doi:10.1111/j.1526-4610.2007.00887.x
136. Choi I, Jeon SR. Neuralgias of the Head: Occipital Neuralgia. J Korean Med Sci. Apr 2016;31(4):479-88. doi:10.3346/jkms.2016.31.4.479
137. Vanelderen P, Lataster A, Levy R, Mekhail N, Van Kleef M, Van Zundert J. 8. Occipital Neuralgia. Pain Practice. 2010;10(2):137-144. doi:https://doi.org/10.1111/j.1533-2500.2009.00355.x
138. Quesnel AM, Lindsay RW, Hadlock TA. When the bell tolls on Bell's palsy: finding occult malignancy in acute-onset facial paralysis. Am J Otolaryngol. Sep-Oct 2010;31(5):339-42. doi:10.1016/j.amjoto.2009.04.003
139. Hermier M. Imaging of hemifacial spasm. Neurochirurgie. May 2018;64(2):117-123. doi:10.1016/j.neuchi.2018.01.005
140. American College of Radiology. ACR Appropriateness Criteria® Cranial Neuropathy. American College of Radiology (ACR). Updated 2022. Accessed January 22, 2023. https://acsearch.acr.org/docs/69509/Narrative/
141. Mumtaz S, Jensen MB. Facial neuropathy with imaging enhancement of the facial nerve: a case report. Future Neurol. Nov 1 2014;9(6):571-576. doi:10.2217/fnl.14.55
142. Yedavalli VS, Patil A, Shah P. Amyotrophic Lateral Sclerosis and its Mimics/Variants: A Comprehensive Review. J Clin Imaging Sci. 2018;8:53. doi:10.4103/jcis.JCIS_40_18
143. King RR, Reiss JP. The epidemiology and pathophysiology of pseudobulbar affect and its association with neurodegeneration. Degener Neurol Neuromuscul Dis. 2013;3:23-31. doi:10.2147/dnnd.S34160
144. Ashwal S, Michelson D, Plawner L, Dobyns WB. Practice parameter: Evaluation of the child with microcephaly (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. Sep 15 2009;73(11):887-97. doi:10.1212/WNL.0b013e3181b783f7
145. Vinocur DN, Medina LS. Imaging in the evaluation of children with suspected craniosynostosis. Evidence-based imaging in pediatrics. Springer; 2010:43-52.
146. Tan AP, Mankad K, Gonçalves FG, Talenti G, Alexia E. Macrocephaly: Solving the Diagnostic Dilemma. Top Magn Reson Imaging. Aug 2018;27(4):197-217. doi:10.1097/rmr.0000000000000170
147. Dougherty H, Shaunak M, Irving M, Thompson D, Cheung MS. Identification of Characteristic Neurological Complications in Infants with Achondroplasia by Routine MRI Screening. ESPE Abstracts. 2018;89
148. Kubota T, Adachi M, Kitaoka T, et al. Clinical Practice Guidelines for Achondroplasia. Clin Pediatr Endocrinol. 2020;29(1):25-42. doi:10.1297/cpe.29.25
149. Ashwal S, Russman BS, Blasco PA, et al. Practice parameter: diagnostic assessment of the child with cerebral palsy: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. Mar 23 2004;62(6):851-63. doi:10.1212/01.wnl.0000117981.35364.1b
150. Cerebral palsy in under 25s: assessment and management National Institute for Health and Care Excellence (NICE). Updated January 25, 2017. Accessed January 23, 2023. https://www.nice.org.uk/guidance/ng62/resources/cerebral-palsy-in-under-25s-assessment-and-management-1837570402501
151. Mallack EJ, Turk BR, Yan H, et al. MRI surveillance of boys with X-linked adrenoleukodystrophy identified by newborn screening: Meta-analysis and consensus guidelines. J Inherit Metab Dis. May 2021;44(3):728-739. doi:10.1002/jimd.12356
152. Whitson WJ, Lane JR, Bauer DF, Durham SR. A prospective natural history study of nonoperatively managed Chiari I malformation: does follow-up MRI surveillance alter surgical decision making? J Neurosurg Pediatr. Aug 2015;16(2):159-66. doi:10.3171/2014.12.Peds14301
153. Damasceno BP. Neuroimaging in normal pressure hydrocephalus. Dement Neuropsychol. Oct-Dec 2015;9(4):350-355. doi:10.1590/1980-57642015dn94000350
154. Kamenova M, Rychen J, Guzman R, Mariani L, Soleman J. Yield of early postoperative computed tomography after frontal ventriculoperitoneal shunt placement. PLoS One. 2018;13(6):e0198752. doi:10.1371/journal.pone.0198752
155. Pople IK. Hydrocephalus and shunts: what the neurologist should know. J Neurol Neurosurg Psychiatry. Sep 2002;73 Suppl 1(Suppl 1):i17-22.doi:10.1136/jnnp.73.suppl_1.i17
156. Reddy GK, Bollam P, Caldito G. Long-term outcomes of ventriculoperitoneal shunt surgery in patients with hydrocephalus. World Neurosurg. Feb 2014;81(2):404-10. doi:10.1016/j.wneu.2013.01.096
157. Wetzel JS, Heaner DP, Gabel BC, Tubbs RS, Chern JJ. Clinical evaluation and surveillance imaging of children with myelomeningocele and shunted hydrocephalus: a follow-up study. J Neurosurg Pediatr. Oct 19 2018;23(2):153-158. doi:10.3171/2018.7.Peds1826
158. Severson M, Strecker-McGraw MK. Cerebrospinal Fluid Leak. StatPearls Publishing. Updated August 8, 2022. Accessed January 23, 2023. https://www.ncbi.nlm.nih.gov/books/NBK538157/
159. Mantur M, Łukaszewicz-Zając M, Mroczko B, et al. Cerebrospinal fluid leakage--reliable diagnostic methods. Clin Chim Acta. May 12 2011;412(11-12):837-40. doi:10.1016/j.cca.2011.02.017
160. Selcuk H, Albayram S, Ozer H, et al. Intrathecal gadolinium-enhanced MR cisternography in the evaluation of CSF leakage. AJNR Am J Neuroradiol. Jan 2010;31(1):71-5. doi:10.3174/ajnr.A1788
161. Gordon N. Spontaneous intracranial hypotension. Dev Med Child Neurol. Dec 2009;51(12):932-5. doi:10.1111/j.1469-8749.2009.03514.x
162. Deline C, Schievink WI, National Organization for Rare Disorders. Spontaneous Intracranial Hypotension. National Organization for Rare Disorders (NORD). Updated September 1, 2020. Accessed January 23, 2023. https://rarediseases.org/rare-diseases/spontaneous-intracranial-hypotension/
163. Bradley WG, Jr. Magnetic Resonance Imaging of Normal Pressure Hydrocephalus. Semin Ultrasound CT MR. Apr 2016;37(2):120-8. doi:10.1053/j.sult.2016.01.005
164. Mohammad SA, Osman NM, Ahmed KA. The value of CSF flow studies in the management of CSF disorders in children: a pictorial review. Insights Imaging. Jan 28 2019;10(1):3. doi:10.1186/s13244-019-0686-x
165. National Organization for Rare Disorders. Chiari Malformations. National Organization for Rare Disorders (NORD). Updated 2014. Accessed January 23, 2023. https://rarediseases.org/rare-diseases/chiari-malformations/
166. Kattah JC, Talkad AV, Wang DZ, Hsieh YH, Newman-Toker DE. HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging. Stroke. Nov 2009;40(11):3504-10. doi:10.1161/strokeaha.109.551234
167. Welgampola MS, Young AS, Pogson JM, Bradshaw AP, Halmagyi GM. Dizziness demystified. Pract Neurol. Dec 2019;19(6):492-501. doi:10.1136/practneurol-2019-002199
168. Yamada S, Yasui K, Kawakami Y, Hasegawa Y, Katsuno M. DEFENSIVE Stroke Scale: Novel Diagnostic Tool for Predicting Posterior Circulation Infarction in the Emergency Department. J Stroke Cerebrovasc Dis. Jun 2019;28(6):1561-1570. doi:10.1016/j.jstrokecerebrovasdis.2019.03.005
169. Felix O, Amaddeo A, Olmo Arroyo J, et al. Central sleep apnea in children: experience at a single center. Sleep Med. Sep 2016;25:24-28. doi:10.1016/j.sleep.2016.07.016
170. Malhotra A, Owens RL. What is central sleep apnea? Respir Care. Sep 2010;55(9):1168-78.
171. Al-Nsoor NM, Mhearat AS. Brain computed tomography in patients with syncope. Neurosciences (Riyadh). Apr 2010;15(2):105-9.
172. Strickberger SA, Benson DW, Biaggioni I, et al. AHA/ACCF Scientific Statement on the evaluation of syncope: from the American Heart Association Councils on Clinical Cardiology, Cardiovascular Nursing, Cardiovascular Disease in the Young, and Stroke, and the Quality of Care and Outcomes Research Interdisciplinary Working Group; and the American College of Cardiology Foundation: in collaboration with the Heart Rhythm Society: endorsed by the American Autonomic Society. Circulation. Jan 17 2006;113(2):316-27. doi:10.1161/circulationaha.105.170274
173. Venkatesan T, Levinthal DJ, Tarbell SE, et al. Guidelines on management of cyclic vomiting syndrome in adults by the American Neurogastroenterology and Motility Society and the Cyclic Vomiting Syndrome Association. Neurogastroenterol Motil. Jun 2019;31 Suppl 2(Suppl 2):e13604. doi:10.1111/nmo.13604
174. Li BUK. Managing cyclic vomiting syndrome in children: beyond the guidelines. Eur J Pediatr. Oct 2018;177(10):1435-1442. doi:10.1007/s00431-018-3218-7
175. Angus-Leppan H, Saatci D, Sutcliffe A, Guiloff RJ. Abdominal migraine. Bmj. Feb 19 2018;360:k179. doi:10.1136/bmj.k179
176. American College of Radiology. ACR Appropriateness Criteria® Soft-Tissue Masses. American College of Radiology. Updated 2022. Accessed January 23, 2023. https://acsearch.acr.org/docs/69434/Narrative/
177. Kim HS, An JK, Woo JJ, Yoon RG. Superficially Palpable Masses of the Scalp and Face: A Pictorial Essay. Journal of the Korean Society of Radiology. 2019;80(2):283-293.
178. Zhang J, Li Y, Zhao Y, Qiao J. CT and MRI of superficial solid tumors. Quant Imaging Med Surg. Mar 2018;8(2):232-251. doi:10.21037/qims.2018.03.03
179. American College of Radiology. ACR Appropriateness Criteria® Acute Mental Status Change, Delirium, and New Onset Psychosis American College of Radiology. Updated 2018. Accessed January 23, 2023. https://acsearch.acr.org/docs/3102409/Narrative/
180. Ali AS, Syed NP, Murthy GS, et al. Magnetic resonance imaging (MRI) evaluation of developmental delay in pediatric patients. J Clin Diagn Res. Jan 2015;9(1):Tc21-4. doi:10.7860/jcdr/2015/11921.5478
181. Momen AA, Jelodar G, Dehdashti H. Brain magnetic resonance imaging findings in developmentally delayed children. Int J Pediatr. 2011;2011:386984. doi:10.1155/2011/386984
182. Tieder JS, Bonkowsky JL, Etzel RA, et al. Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants: Executive Summary. Pediatrics. May 2016;137(5)doi:10.1542/peds.2016-0591
183. Gerull S, Medinger M, Heim D, Passweg J, Stern M. Evaluation of the Pretransplantation Workup before Allogeneic Transplantation. Biology of Blood and Marrow Transplantation. 2014/11/01/ 2014;20(11):1852-1856. doi:https://doi.org/10.1016/j.bbmt.2014.06.029
184. Kaste SC, Kaufman RA, Sunkara A, et al. Routine pre- and post-hematopoietic stem cell transplant computed tomography of the abdomen for detecting invasive fungal infection has limited value. Biol Blood Marrow Transplant. Jun 2015;21(6):1132-5. doi:10.1016/j.bbmt.2015.02.023
185. Joshi VM, Navlekar SK, Kishore GR, Reddy KJ, Kumar EC. CT and MR imaging of the inner ear and brain in children with congenital sensorineural hearing loss. Radiographics. May-Jun 2012;32(3):683-98. doi:10.1148/rg.323115073
186. Dewan K, Wippold FJ, 2nd, Lieu JE. Enlarged vestibular aqueduct in pediatric sensorineural hearing loss. Otolaryngol Head Neck Surg. Apr 2009;140(4):552-8. doi:10.1016/j.otohns.2008.12.035
187. Ralli M, Rolesi R, Anzivino R, Turchetta R, Fetoni AR. Acquired sensorineural hearing loss in children: current research and therapeutic perspectives. Acta Otorhinolaryngol Ital. Dec 2017;37(6):500-508. Sordità infantile acquisita: stato dell’arte della ricerca e prospettive terapeutiche. doi:10.14639/0392-100x-1574

188. Hiremath SB, Gautam AA, Sasindran V, Therakathu J, Benjamin G. Cerebrospinal fluid rhinorrhea and otorrhea: A multimodality imaging approach. Diagn Interv Imaging. Jan 2019;100(1):3-15. doi:10.1016/j.diii.2018.05.003
189. Patel KM, Almutairi A, Mafee MF. Acute otomastoiditis and its complications: Role of imaging. Operative Techniques in Otolaryngology-Head and Neck Surgery. 2014/03/01 2014;25(1):21-28. doi:https://doi.org/10.1016/j.otot.2013.11.004
190. Platzek I, Kitzler HH, Gudziol V, Laniado M, Hahn G. Magnetic resonance imaging in acute mastoiditis. Acta Radiol Short Rep. Feb 2014;3(2):2047981614523415. doi:10.1177/2047981614523415
191. Radiology ACo. ACR Appropriateness Criteria® ACR-ASNR-SPR Practice Parameter for the Performance of Intracranial Magnetic Resonance Perfusion Imaging. 2022. Updated 2022. Accessed April 26, 2023. https://www.acr.org/-/media/ACR/Files/Practice-Parameters/MR-Perfusion.pdf
192. Suh CH, Kim HS, Jung SC, Choi CG, Kim SJ. Perfusion MRI as a diagnostic biomarker for differentiating glioma from brain metastasis: a systematic review and meta-analysis. Eur Radiol. Sep 2018;28(9):3819-3831. doi:10.1007/s00330-018-5335-0
193. Arevalo-Perez J, Peck KK, Young RJ, Holodny AI, Karimi S, Lyo JK. Dynamic Contrast-Enhanced Perfusion MRI and Diffusion-Weighted Imaging in Grading of Gliomas. J Neuroimaging. Sep-Oct 2015;25(5):792-8. doi:10.1111/jon.12239
194. Metaweh NAK, Azab AO, El Basmy AAH, Mashhour KN, El Mahdy WM. Contrast-Enhanced Perfusion MR Imaging to Differentiate Between Recurrent/Residual Brain Neoplasms and Radiation Necrosis. Asian Pac J Cancer Prev. Apr 25 2018;19(4):941-948. doi:10.22034/apjcp.2018.19.4.941
195. Wang L, Wei L, Wang J, et al. Evaluation of perfusion MRI value for tumor progression assessment after glioma radiotherapy: A systematic review and meta-analysis. Medicine (Baltimore). Dec 24 2020;99(52):e23766. doi:10.1097/md.0000000000023766
196. Lawson GR. Controversy: Sedation of children for magnetic resonance imaging. Arch Dis Child. Feb 2000;82(2):150-3. doi:10.1136/adc.82.2.150
197. Whitehead MT, Cardenas AM, Corey AS, et al. ACR Appropriateness Criteria® Headache. J Am Coll Radiol. Nov 2019;16(11s):S364-s377. doi:10.1016/j.jacr.2019.05.030
198. Yeh YC, Fuh JL, Chen SP, Wang SJ. Clinical features, imaging findings and outcomes of headache associated with sexual activity. Cephalalgia. Nov 2010;30(11):1329-35. doi:10.1177/0333102410364675
199. Yuan MK, Lai PH, Chen JY, et al. Detection of subarachnoid hemorrhage at acute and subacute/chronic stages: comparison of four magnetic resonance imaging pulse sequences and computed tomography. J Chin Med Assoc. Mar 2005;68(3):131-7. doi:10.1016/s1726-4901(09)70234-5
200. Chen CY, Fuh JL. Evaluating thunderclap headache. Curr Opin Neurol. Jun 1 2021;34(3):356-362. doi:10.1097/wco.0000000000000917
201. Pegge SAH, Steens SCA, Kunst HPM, Meijer FJA. Pulsatile Tinnitus: Differential Diagnosis and Radiological Work-Up. Curr Radiol Rep. 2017;5(1):5. doi:10.1007/s40134-017-0199-7
202. Yew KS. Diagnostic approach to patients with tinnitus. Am Fam Physician. Jan 15 2014;89(2):106-13.

203. Wingerchuk DM, Banwell B, Bennett JL, et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. Jul 14 2015;85(2):177-89. doi:10.1212/wnl.0000000000001729
204. Kaunzner UW, Gauthier SA. MRI in the assessment and monitoring of multiple sclerosis: an update on best practice. Ther Adv Neurol Disord. Jun 2017;10(6):247-261. doi:10.1177/1756285617708911
205. Radic JAE, Cochrane DD. Choosing Wisely Canada: Pediatric Neurosurgery Recommendations. Paediatr Child Health. Sep 2018;23(6):383-387. doi:10.1093/pch/pxy012
206. Shah LM, Salzman KL. Imaging of spinal metastatic disease. Int J Surg Oncol. 2011;2011:769753. doi:10.1155/2011/769753
207. Behbehani R. Clinical approach to optic neuropathies. Clin Ophthalmol. Sep 2007;1(3):233-46.
208. Margolin E. The swollen optic nerve: an approach to diagnosis and management. Pract Neurol. Aug 2019;19(4):302-309. doi:10.1136/practneurol-2018-002057
209. Kaur K, Gurnani B, Devy N. Atypical optic neuritis - a case with a new surprise every visit. GMS Ophthalmol Cases. 2020;10:Doc11. doi:10.3205/oc000138
210. Phuljhele S, Kedar S, Saxena R. Approach to optic neuritis: An update. Indian J Ophthalmol. Sep 2021;69(9):2266-2276. doi:10.4103/ijo.IJO_3415_20
211. de Graaf P, Göricke S, Rodjan F, et al. Guidelines for imaging retinoblastoma: imaging principles and MRI standardization. Pediatr Radiol. Jan 2012;42(1):2-14. doi:10.1007/s00247-011-2201-5
212. Razek AA, Elkhamary S. MRI of retinoblastoma. Br J Radiol. Sep 2011;84(1005):775-84. doi:10.1259/bjr/32022497
213. Pakalniskis MG, Berg AD, Policeni BA, et al. The Many Faces of Granulomatosis With Polyangiitis: A Review of the Head and Neck Imaging Manifestations. AJR Am J Roentgenol. Dec 2015;205(6):W619-29. doi:10.2214/ajr.14.13864
214. Hughes MA, Frederickson AM, Branstetter BF, Zhu X, Sekula RF, Jr. MRI of the Trigeminal Nerve in Patients With Trigeminal Neuralgia Secondary to Vascular Compression. AJR Am J Roentgenol. Mar 2016;206(3):595-600. doi:10.2214/ajr.14.14156
215. Jang YE, Cho EY, Choi HY, Kim SM, Park HY. Diagnostic Neuroimaging in Headache Patients: A Systematic Review and Meta-Analysis. Psychiatry Investig. Jun 2019;16(6):407-417. doi:10.30773/pi.2019.04.11
216. Spierings EL. Acute, subacute, and chronic headache. Otolaryngol Clin North Am. Dec 2003;36(6):1095-107, vi. doi:10.1016/s0030-6665(03)00128-2
217. Tyagi A. New daily persistent headache. Ann Indian Acad Neurol. Aug 2012;15(Suppl 1):S62-5. doi:10.4103/0972-2327.100011
218. Hadjikhani N, Vincent M. Neuroimaging clues of migraine aura. J Headache Pain. Apr 3 2019;20(1):32. doi:10.1186/s10194-019-0983-2
219. Chhetri SK, Gow D, Shaunak S, Varma A. Clinical assessment of the sensory ataxias; diagnostic algorithm with illustrative cases. Pract Neurol. Aug 2014;14(4):242-51. doi:10.1136/practneurol-2013-000764
220. Foster H, Drummond P, Jandial S, Clinch J, Wood M, Driscoll S. Evaluation of gait disorders in children. BMJ Best Practice. Updated February 23, 2021. Accessed January 23, 2023. https://bestpractice.bmj.com/topics/en-us/709
221. Standford Medicine. Gait Abnormalities. Stanford University. Accessed January 23, 2023. https://stanfordmedicine25.stanford.edu/the25/gait.html
222. Haynes KB, Wimberly RL, VanPelt JM, Jo CH, Riccio AI, Delgado MR. Toe Walking: A Neurological Perspective After Referral From Pediatric Orthopaedic Surgeons. J Pediatr Orthop. Mar 2018;38(3):152-156. doi:10.1097/bpo.0000000000001115
223. Marshall FJ. Approach to the elderly patient with gait disturbance. Neurol Clin Pract. Jun 2012;2(2):103-111. doi:10.1212/CPJ.0b013e31825a7823
224. Pirker W, Katzenschlager R. Gait disorders in adults and the elderly : A clinical guide. Wien Klin Wochenschr. Feb 2017;129(3-4):81-95. doi:10.1007/s00508-016-1096-4
225. Sacco RL, Kasner SE, Broderick JP, et al. An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. Jul 2013;44(7):2064-89. doi:10.1161/STR.0b013e318296aeca
226. Kernan WN, Ovbiagele B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. Jul 2014;45(7):2160-236. doi:10.1161/str.0000000000000024
227. Easton JD, Saver JL, Albers GW, et al. Definition and evaluation of transient ischemic attack: a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease. The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists. Stroke. Jun 2009;40(6):2276-93. doi:10.1161/strokeaha.108.192218
228. Hong KS, Yegiaian S, Lee M, Lee J, Saver JL. Declining stroke and vascular event recurrence rates in secondary prevention trials over the past 50 years and consequences for current trial design. Circulation. May 17 2011;123(19):2111-9. doi:10.1161/circulationaha.109.934786
229. Wintermark M, Sanelli PC, Albers GW, et al. Imaging recommendations for acute stroke and transient ischemic attack patients: A joint statement by the American Society of Neuroradiology, the American College of Radiology, and the Society of NeuroInterventional Surgery. AJNR Am J Neuroradiol. Nov-Dec 2013;34(11):E117-27. doi:10.3174/ajnr.A3690
230. Robertson RL, Palasis S, Rivkin MJ, et al. ACR Appropriateness Criteria® Cerebrovascular Disease-Child. J Am Coll Radiol. May 2020;17(5s):S36-s54. doi:10.1016/j.jacr.2020.01.036
231. Salmela MB, Mortazavi S, Jagadeesan BD, et al. ACR Appropriateness Criteria(®) Cerebrovascular Disease. J Am Coll Radiol. May 2017;14(5s):S34-s61. doi:10.1016/j.jacr.2017.01.051
232. Lee M, Kim MS. Image findings in brain developmental venous anomalies. J Cerebrovasc Endovasc Neurosurg. Mar 2012;14(1):37-43. doi:10.7461/jcen.2012.14.1.37
233. Jensen RH, Radojicic A, Yri H. The diagnosis and management of idiopathic intracranial hypertension and the associated headache. Ther Adv Neurol Disord. Jul 2016;9(4):317-26. doi:10.1177/1756285616635987
234. Connors JM, Levy JH. Thromboinflammation and the hypercoagulability of COVID-19. J Thromb Haemost. Jul 2020;18(7):1559-1561. doi:10.1111/jth.14849.

235. Tu TM, Goh C, Tan YK, et al. Cerebral Venous Thrombosis in Patients with COVID-19 Infection: a Case Series and Systematic Review. J Stroke Cerebrovasc Dis. Dec 2020;29(12):105379. doi:10.1016/j.jstrokecerebrovasdis.2020.105379
236. Coutinho JM. Cerebral venous thrombosis. J Thromb Haemost. Jun 2015;13 Suppl 1:S238-44. doi:10.1111/jth.12945
237. Ferro JM, Canhão P, Aguiar de Sousa D. Cerebral venous thrombosis. Presse Med. Dec 2016;45(12 Pt 2):e429-e450. doi:10.1016/j.lpm.2016.10.007
238. Atluri S, Sarathi V, Goel A, Boppana R, Shivaprasad C. Etiological Profile of Galactorrhoea. Indian J Endocrinol Metab. Jul-Aug 2018;22(4):489-493. doi:10.4103/ijem.IJEM_89_18
239. Huang W, Molitch ME. Evaluation and management of galactorrhea. Am Fam Physician. Jun 1 2012;85(11):1073-80.
240. Melmed S, Casanueva FF, Hoffman AR, et al. Diagnosis and Treatment of Hyperprolactinemia: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism. 2011;96(2):273-288. doi:10.1210/jc.2010-1692
241. Kamihara J, Bourdeaut F, Foulkes WD, et al. Retinoblastoma and Neuroblastoma Predisposition and Surveillance. Clin Cancer Res. Jul 1 2017;23(13):e98-e106. doi:10.1158/1078-0432.Ccr-17-0652
242. Grasparil AD, Gottumukkala RV, Greer M-LC, Gee MS. Whole-Body MRI Surveillance of Cancer Predisposition Syndromes: Current Best Practice Guidelines for Use, Performance, and Interpretation. American Journal of Roentgenology. 2020/10/01 2020;215(4):1002-1011. doi:10.2214/AJR.19.22399
243. Borofsky S, Levy LM. Neurofibromatosis: types 1 and 2. AJNR Am J Neuroradiol. Dec 2013;34(12):2250-1. doi:10.3174/ajnr.A3534
244. Rovira À, Wattjes MP, Tintoré M, et al. Evidence-based guidelines: MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis-clinical implementation in the diagnostic process. Nat Rev Neurol. Aug 2015;11(8):471-82. doi:10.1038/nrneurol.2015.106
245. Saguil A, Kane S, Farnell E. Multiple sclerosis: a primary care perspective. Am Fam Physician. Nov 1 2014;90(9):644-52.
246. Larivière D, Sacre K, Klein I, et al. Extra- and intracranial cerebral vasculitis in giant cell arteritis: an observational study. Medicine (Baltimore). Dec 2014;93(28):e265. doi:10.1097/md.0000000000000265
247. Geyer M, Nilssen E. Evidence-based management of a patient with anosmia. Clin Otolaryngol. Oct 2008;33(5):466-9. doi:10.1111/j.1749-4486.2008.01819.x
248. Lechien JR, Chiesa-Estomba CM, De Siati DR, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol. Aug 2020;277(8):2251-2261. doi:10.1007/s00405-020-05965-1
249. Saniasiaya J, Islam MA, Abdullah B. Prevalence of Olfactory Dysfunction in Coronavirus Disease 2019 (COVID-19): A Meta-analysis of 27,492 Patients. Laryngoscope. Apr 2021;131(4):865-878. doi:10.1002/lary.29286
250. Smith R, Leonidas JC, Maytal J. The value of head ultrasound in infants with macrocephaly. Pediatr Radiol. Mar 1998;28(3):143-6. doi:10.1007/s002470050315
251. Pindrik J, Ye X, Ji BG, Pendleton C, Ahn ES. Anterior fontanelle closure and size in full-term children based on head computed tomography. Clin Pediatr (Phila). Oct 2014;53(12):1149-57. doi:10.1177/0009922814538492

252. Cooper AS, Friedlaender E, Levy SE, et al. The Implications of Brain MRI in Autism Spectrum Disorder. J Child Neurol. Dec 2016;31(14):1611-1616. doi:10.1177/0883073816665548
253. Andersen BM, Miranda C, Hatzoglou V, DeAngelis LM, Miller AM. Leptomeningeal metastases in glioma: The Memorial Sloan Kettering Cancer Center experience. Neurology. May 21 2019;92(21):e2483-e2491. doi:10.1212/wnl.0000000000007529
254. Clarke JL, Perez HR, Jacks LM, Panageas KS, Deangelis LM. Leptomeningeal metastases in the MRI era. Neurology. May 4 2010;74(18):1449-54. doi:10.1212/WNL.0b013e3181dc1a69
255. Maillie L, Salgado LR, Lazarev S. A systematic review of craniospinal irradiation for leptomeningeal disease: past, present, and future. Clin Transl Oncol. Oct 2021;23(10):2109-2119. doi:10.1007/s12094-021-02615-8
256. Wang N, Bertalan MS, Brastianos PK. Leptomeningeal metastasis from systemic cancer: Review and update on management. Cancer. Jan 1 2018;124(1):21-35. doi:10.1002/cncr.30911
257. Ahmed A. MRI features of disseminated 'drop metastases'. S Afr Med J. Jul 2008;98(7):522-3.

ADDITIONAL RESOURCES

1. Radmanesh A, Raz E, Zan E, Derman A, Kaminetzky M. Brain Imaging Use and Findings in COVID-19: A Single Academic Center Experience in the Epicenter of Disease in the United States. AJNR Am J Neuroradiol. Jul 2020;41(7):1179-1183. doi:10.3174/ajnr.A6610
2. Naelitz B, Shah A, Nowacki AS, et al. Prolactin-to-Testosterone Ratio Predicts Pituitary Abnormalities in Mildly Hyperprolactinemic Men with Symptoms of Hypogonadism. J Urol. 2021;205(3):871-878. doi:10.1097/JU.0000000000001431

Coding Section 

Procedure and diagnosis codes on Medical Policy documents are included only as a general reference tool for each policy. They may not be all-inclusive. 

This medical policy was developed through consideration of peer-reviewed medical literature generally recognized by the relevant medical community, U.S. FDA approval status, nationally accepted standards of medical practice and accepted standards of medical practice in this community, and other nonaffiliated technology evaluation centers, reference to federal regulations, other plan medical policies, and accredited national guidelines.

"Current Procedural Terminology © American Medical Association. All Rights Reserved" 

History From 2019 Forward