ACE Clinical Guidances (ACGs)

ACGs* provide concise, evidence-based recommendations to inform specific areas of clinical practice and serve as a common starting point nationally for clinical decision-making. ACGs are underpinned by a wide array of considerations contextualised to Singapore, based on best available evidence at the time of development. Each ACG is developed in collaboration with a multidisciplinary group of local experts representing relevant specialties and practice settings. ACGs are not exhaustive of the subject matter and do not replace clinical judgement. 

Registered doctors, pharmacists and nurses may claim 1 Continuing Medical Education (CME)/Continuing Professional Education (CPE) point under category 3A/ Category V-B for reading each ACG.

*previously known as Appropriate Care Guides
Published on 31 Aug 2022
Last Updated on 31 Aug 2022
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This ACE Clinical Guidance (ACG) covers the use of CT/MRI brain for diagnostic investigation of headache, providing evidence-based recommendations on the role of CT/MRI brain for primary and secondary headaches.

Download the PDF below to access the ACG.
Registered doctors and pharmacists may claim 1 Continuing Medical Education (CME)/Continuing Professional Education (CPE) point under category 3A for reading each ACG.

ACG recommendations
1.Patients with migraine or TTH, without red flags: CT is not indicated; MRI is not indicated.
2.Patients with cluster headache or other trigeminal autonomic cephalalgias, without red flags: CT may be indicated; MRI is indicated.
3.Patients with sudden, severe headache: CT is indicated; MRI may be indicated.
4.Patients with headache and cancer or infection (suspected or known): CT may be indicated; MRI is indicated.
5.Patients with post-traumatic headache: CT is indicated; MRI may be indicated.
6.Patients with new headache accompanied by red flags, or with worsening headache: CT may be indicated; MRI is indicated.

When to order CT/MRI for headache (August 2022)

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