Overview of Headache in the Emergency Department
- 609 Downloads
Key Chapter Points
About 2–3% of all ED visits are for headache. Migraine is the #1 diagnosis for nontraumatic headache seen in the emergency department, accounting for 40–60% of all nontraumatic, emergency department headaches. While migraine sufferers usually obtain routine headache care with outpatient providers, ED treatment is generally sought when pain becomes unbearable, patient’s current headache regimen is not effective, or a patient’s primary headache provider is unavailable. ED visits are expensive and often very frustrating for staff and patients. Common errors of ED headache assessment include focusing on identifying a specific primary headache diagnosis rather than distinguishing primary from secondary headaches, misunderstanding the role of hypertension, failing to identify unreported trauma, and using treatment response to confirm a diagnosis.
KeywordsAcute migraine Cost Nausea Nontraumatic
- 2.http://www.neurologyreviews.com/sep06/headache.html. Accessed Jun 2010.
- 3.American Board of Emergency Medicine website. http://www.abem.org. Accessed Jun 2010.
- 4.Headache Classification Subcommittee of the International Headache Society. The international classification of headache disorders. 2nd edition. Cephalalgia. 2004;24 Suppl 1:1–160.Google Scholar
- 15.Friedman BW, Hochberg ML, Esses D, et al. Applying the International Classification of Headache Disorders to the emergency department: an assessment of reproducibility and the frequency with which a unique diagnosis can be assigned to every acute headache presentation. Ann Emerg Med. 2007;49:409–19.PubMedCrossRefGoogle Scholar
- 35.th report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Available at the National Heart, Lung, and Blood Institute website http://www.nhlbi.nih.gov. Accessed Jan 2011.
- 36.Ang SH, Chan YC, Mah M. Emergency department headache admission in an acute care hospital: why do they occur and what can we do about it? Ann Acad Med Sing. 2009;38:1007–10.Google Scholar