DOI: 10.1097/01.EEM.0000527806.85058.ba
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Issn Print: 1054-0725
Publication Date: 2017/12/01
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Excerpt
Headache is a common presentation to the emergency department, and the diagnosis is often relatively straightforward. It's not that difficult to make a diagnosis of headache caused by meningitis, intracranial hemorrhage, or brain tumor—tests can readily substantiate these diagnoses.
Most causes of headache are benign and only vaguely understood or accurately diagnosed in the ED. Many patients are treated and released without a definitive diagnosis because clinicians usually label them tension headaches or sinusitis. Migraine headaches are actually quite common and the leading cause of time spent disabled. Migraines are often relatively classic in their presentation, and can usually be handled with simple attempts at pain relief, but the first-time migraine headache is a challenge to emergency physicians. Migraines also have multiple treatment regimens, many with reasonable results, though the specific treatment is often based on the preference of the individual provider. The most specific way to confirm the diagnosis of migraine headache includes a careful history and exam, clinical gestalt, and a few simple tests.
