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Related Experiment Video

Updated: Mar 3, 2026

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
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[Headache in the emergency department].

C J Schankin1, A Straube2, C L Bassetti3

  • 1Neurologische Klinik, Inselspital, Universitätsspital Bern, Universität Bern, Bern, Schweiz. christoph.schankin@insel.ch.

Der Nervenarzt
|May 4, 2017
PubMed
Summary

This study presents a practical algorithm for emergency department headache evaluations. It emphasizes detailed history, targeted examination, and appropriate investigations to differentiate primary and secondary headaches for effective management.

Keywords:
AlgorithmEmergencyLeading symptomOutpatient follow-upWarning signs

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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.