[Headache in the emergency department]

Area of Science:

• Neurology
• Emergency Medicine

Background:

• Headache is a common reason for emergency department visits.
• Effective management requires differentiating primary from secondary causes.

Purpose of the Study:

• To present a pragmatic algorithm for evaluating headache patients in the emergency department.
• To guide clinicians in diagnosing and managing various headache types.

Main Methods:

• Detailed patient history focusing on headache dynamics, phenotype, and triggers.
• Specific interrogation for "red flags" indicative of serious conditions.
• Clinical examination including vital signs and neurological assessment.
• Diagnostic workup with imaging, laboratory tests, and cerebrospinal fluid analysis.

Main Results:

• The algorithm facilitates the generation and testing of etiological hypotheses.
• Enables causal treatment for secondary headaches and specific therapy for primary headaches.
• Recommends follow-up for discharged patients to monitor for secondary headache development.

Conclusions:

• A structured approach improves emergency department headache management.
• Timely diagnosis and appropriate treatment reduce complications and prevent revisits.
• Optimizing prophylaxis and acute therapy for primary headaches is crucial.