American Board of Internal Medicine (ABIM) Certification Practice Exam

What duration of neurologic symptoms would prompt imaging for headaches?

1. Less than 30 minutes

2. Greater than 1 hour

3. Less than 1 hour

4. Persistent for 12 hours

The correct answer is: Greater than 1 hour

Imaging for headaches is often indicated when patients experience neurologic symptoms that persist for more than one hour. This threshold is significant because temporary or transient neurologic symptoms, particularly those lasting less than one hour, are frequently related to benign conditions like migraines or tension-type headaches and may not warrant immediate imaging. When neurologic symptoms extend beyond one hour, there is a higher concern for potential underlying serious conditions, such as intracranial lesions (tumors, hemorrhages, etc.) or vascular issues (e.g., strokes). Recognizing the duration of symptoms is crucial; longer-lasting symptoms may suggest that a more thorough evaluation, including imaging, is necessary to rule out these serious pathologies. In summary, if symptoms persist for greater than one hour, imaging becomes an important tool for clinicians to identify or exclude more serious neurological conditions that could require urgent intervention or management.