Final answer:
Neuroimaging is typically recommended for migraines when there is a new or changed headache pattern, especially if the patient is over 40 years old, which could indicate an underlying condition requiring further investigation.
Step-by-step explanation:
The question is regarding when neuroimaging is required for a patient experiencing a migraine. Neuroimaging is not typically required for migraines, as they are often diagnosed based on clinical history and symptoms. However, neuroimaging may be recommended in certain situations, such as when a patient's headache pattern changes or becomes more severe, suggesting the possibility of a secondary headache or when a patient presents with neurological symptoms that are not typical for a migraine, which might indicate a more serious condition such as a stroke or brain tumor.
Option b) 'When the patient is over 40 years old and has a new or changed headache pattern' would be the most appropriate circumstance among the provided choices to consider neuroimaging. New or significantly changed headache patterns in someone over 40 could signify a different underlying condition that requires further investigation. Aura, family history, and the duration of the migraine attack itself (unless accompanied by atypical signs or symptoms) are not generally indications for neuroimaging.