Leshogo, Keobakile Geofrey2023-02-092023-02-092022https://hdl.handle.net/10539/34444A research report submitted in partial fulfilment of the requirements for the degree of Master of Medicine in n Neurology to the Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, 2022Introduction Common primary headache disorders include migraine, mixed migraine and tension-type headache (TTH). To date, white matter lesions (WMLs) are not described in black patients with primary headache disorders. Our study aims to describe the WMLs on magnetic resonance imaging (MRI) scans of brain in black patients with primary headache disorders and compare our findings to the estimated frequencies reported in other population groups. Methods The records of 79 black adult patients ( ≥18years ) with primary headache disorders and magnetic resonance imaging (MRI) scans of brain were retrospectively reviewed and directly examined for WMLs and their sites of location in the brain. Patients were stratified into two groups; WMLs present and WMLs absent. Secondary causes of WMLs were excluded. Frequency tables were computed and reported. Results Of the 79 patients with primary headache disorders, 34 (43%) had migraines, 35 (44.3%) had TTH, and 10 (12.7%) had unclassified primary headache disorders. The WMLs were present in 38 (48.1%) patients and absent in 41 (51.9%). Their presence, compared to other population groups showed no significant difference (43% vs 48.1% : p-value= 0.4777) . The location of WMLs in parietal lobe showed no significant difference (44.7% vs 47% :- pvalue = 0.7766) and in frontal lobe showed significant difference (92.1% vs 47% :- p-value = < 0.0001). They were present with the following frequencies in different primary headache disorders; 17 (44.7%) in TTH, 14 (36.8%) in migraines and 7 (18.4%) in unclassified primary headache disorders. WMLs were found to be more in the age group 40-45 (44.7%), followed by 30-39 (39.5%) and then 18-29 (15.8%) Conclusion WMLs are present on MRI scans of brain in black patients with primary headache disorders. They are found more in the frontal lobe than other brain sites and tend to be more in TTH and migraineurs. Their presence increase with ageing. In our study, 52% of patients with primary headaches had normal MRI brain scans.enThesis