Headache in the Emergency Department: Avoiding Misdiagnosis of Dangerous Secondary Causes, An Update

In the initial assessment of the headache patient, the emergency physician must consider several dangerous secondary causes of headache. A thorough history and physical examination, along with consideration of a comprehensive differential diagnosis may alert the emergency physician to the diagnosis of a secondary headache particularly when the history is accompanied by any of the following clinical features: sudden/severe onset, focal neurologic deficits, altered mental status, advanced age, active or recent pregnancy, coagulopathy, malignancy, fever, visual deficits, and/or loss of consciousness.