[Headache presenting to a casualty service: four year experience at an Emergency Headache Center]

We report our 4-year experience at the Lariboisiere Hospital Emergency Headache Center. During this period, we provided care for 33,000 patients, two-thirds women, one-third men, 77 percent aged 20-50 years, 90 percent residing in Paris or the suburban areas. About two-thirds of our patients complained of primary headache, i.e migraine, tension type headache or cluster headache, but the number of patients with secondary headache has progressively increased to account for about 17.5 percent of our current recruitment. Vascular headache, particularly after meningeal hemorrhage has been prevalent, leading to an increasing number of orders for biological and radiological explorations as well as hospitalizations.