um custo de $18.811 para o diagnostico de uma alteracao (aneurisma de arteria comunicante posterior a direita) tratavel cirurgicamente(7).Um trabalho nacional analisou a demanda por TCC, ressaltando indicacoes e custos que demonstrou ainda uma analise quanto as entidades que custearam os exames (seguros saude, Inamps e particulares). A conclusao foi que os seguros saude tiveram a maior proporcao de exames normais e, portanto, coube a eles um custo 2,2 vezes maior quando comparados ao Inamps e 2,8 vezes mais em relacao aos da clinica privada(25).CONCLUSOESTendo em vista os altos valores envolvidos na investigacao utilizando TCC, ressaltamos a importancia do aprimoramento da semiotecnica e relacao medico-paciente, estabelecida em clima de maxima confianca, sendo necessario mais estudos abordando este assunto, no intuito de direcionar de forma mais objetiva e efetiva os recursos financeiros destinados aos metodos diagnosticos na avaliacao das cefaleias.Bibliografia1. Akpek S; Arac M. Cost-effectiveness of computed tomography in the evaluation of patients with headache. Headache 1995; 35:228-230.2. Larson EB; Omenn GS; Lewis H. Diagnostic evaluation of headache. JAMA 1980; 243:359-362.3. Medina LS; Pinter JD; Zurakowski D et al. Children with headache: clinical predictors of surgical space-occupying lesions and the role of neuroimaging. Radiology 1997; 202: 819-824.4. Farias da Silva W. Cefaleias: diagnostico e tratamento. 1a ed. 3-4.MEDSI. Rio de Janeiro, 1989.5. Vincent, M.B. et al. Prevalencia e custos indiretos das cefaleias em uma empresa brasileira. Arquivos de Neuropsiquiatria 1998; 56:734-743.6. Frishberg BM. The utility of neuroimaging in the evaluation of headache in patients with normal neurologic examination. Neurology 1994; 44:1191-1197.7. Dumas MD; Pexman JH; Kreeft JH. Computed tomography evaluation of patients with chronic headache. Canadian Medical Association Journal 1994; 151:1447-1452.8. Kahn CE Jr.; Sanders GD. Computed tomography for nontraumatic headaches current utilization and cost-effectiveness. Canadian Association of Radiologists Journal 1993; 44:189-193.9. Mitchel C; Osborn R; Grosskreutz S. Computed tomography in the headache patient: is routine realy necessary? Headache 1993; 33:82-86.10. Verma A; Rosenfeld V; Forteza A; Sharma KR. Occipital lobe tumor presenting as migraine with typical aura. Headache 1996; 36:49-52.11. Sargent JD; Lawson RC; Solbach P; Coyne L. Use of CT scans in an out-patient headache population: an evaluation. Headache 1979; 19: 388-390.12. Hounsfield GN. Computerized transverse axial scanning (tomography): Part I. Description of system. British Journal of Radiology 1973; 46:1016-1022.13. Lance JW, Goadsby PJ. Mechanism and management of headache. 6a ed. 293-294 Boston 1999.14. Oldendorf WH. The quest for an image of brain: a brief historical and technical review of brain imaging techniques. Neurology 1978; 28:517-533.15. Demaerel P; Boelaert I; Wilms G; Baert AL. The role of cranial computed tomography in the diagnostic work-up of headache. Headache 1996; 36:347-348.16. Cuetter A, Aita J. CT scanning in classic migraine [carta]. Headache 1983; 23:195.17. Ad Hoc Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia 1988; 8 (suppl):7.18. NIH Consensus Development Conference Statment Computed Tomograph Scanning of the Brain. Journal of Oklahoma State Medical Association 1981; 75:147-152.19. Sinclair DE; Kovacs G; Hillis M. Cranial CT scans-emergency department utilization. Journal of Emergency Medicine 1993; 11:643-646.20. Sexton CC; Caples C. Emergency CT of the