General Treatment Strategies


Key Chapter Points

Initial treatment for patients with non-traumatic, primary headache includes rehydration and aggressive treatment of nausea. Patients with severe headache pain may need treatment with headache-specific therapies (i.e., triptans or dihydroergotamine) or non-opioid analgesics (i.e., ketorolac). Additional options include intravenous magnesium, intravenous valproate, trigger point injections, and occipital nerve blocks. Steroids offer minimal benefit, although intravenous dexamethasone may help patients with disabling primary headache lasting over 3 days. Opioids should be reserved for rescue therapy in the ED and not routinely used provided as take-home medication.


Anti-emetic Hydration Injection Occipital nerve block Trigger point 


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of AnesthesiologyUniversity of PittsburghPittsburghUSA
  2. 2.Dean Health SystemsMadisonUSA

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