Scientific Online Resource System

International Bulletin of Otorhinolaryngology

Meaning of Headache at the Emergency Department

Onur Incealtin

Abstract

AIM: We investigated the meaning of headache in the emergency room, as a precursor symptom of structural or systemic disorders, especially life-threatening neurological disorders, or as one of the other headaches unrelated to structural disorders in patients who applied to the emergency department with headache complaints. The causes of primary and secondary headaches should be carefully differentiated from each other at the emergency situations.
METHODS: Patients aged 18 years and older, who applied to the Emergency Department of the Faculty of Medicine of 19 Mayis University, with a complaint of headache were included in the study. Primary headaches were divided into subtypes according to the IHS (International Headache Society) classification. Secondary headaches were divided into two subgroups as neurological and nonneurological.
RESULTS: 200 patients, 112 women and 88 men, who applied to the emergency department with the complaint of headache, were included in the study. Migraine was found in 48 patients, tension-type headache in 29 patients, cerebrovascular disease in 52 patients, CNS infection in 4 patients, intracranial mass in 11 patients, traumatic bleeding in 6 patients, psychiatric disorders in 8 patients, sinusitis in 9 patients, and metabolic disease in 22 patients. Cranial CT was normal in 10 patients with primary headache, cerebral hemorrhage in one patient and cerebral edema was found in one patient. Cranial CT was normal in 18 patients with secondary headache, SAH in 40 patients, intracerebral hemorrhage in 4 patients, intracranial mass in 10 patients, subdural hematoma in 4 patients, cerebral edema and ischemia in 6 patients, and epidural hematoma were found in 1
patient.
CONCLUSION: The causes of patients presenting to the emergency department with headache were cerebrovascular disease, migraine, and tension-type headache. In our study, the most common cause was cerebrovascular disease. The prevalence of migraine varies between 3.4-6.1% in men and 12.9-17.7% in women. In our study, the incidence of migraine was 23%, and it was seen 3 times more in women than in men.

Keywords

Emergency Department, Primary Headache, Secondary Headache, Migraine

Full Text


References

Kelly AM, Kuan WS, Chu KH, Kinnear FB, Keijzers G, Karamercan MA, Klim S, Wijeratne T, Kamona S, Graham CA, Body R, Roberts T, Horner D, Laribi S; and the HEAD Study Group. Epidemiology, investigation, management, and outcome of headache in emergency departments (HEAD study)- A multinational observational study. Headache. 2021 Nov 2. doi: 10.1111/head.14230

Dawson JA. Your questions answered migrain and other headaches. Churchill Livingstone; London 2003.

Aygun,D, Bildik F. Clinical warning criteria in evaluation by computed tomography the secondary neurological headaches in adults. Eur J of Neurol 2003; 10: 437–442. https://doi.org/10.1046/j.1468-1331.2003.00645.x

Bobker SM, Safdieh JE. Approach to Headache. Semin Neurol. 2021 Dec; 41(6): 633–643. doi:10.1055/s-0041-1726360.

Newman LC, Lipton RB. Emergency department evalutiopn of headache. Neurol Clin 1988; 16: 285–303

Ng JY, Hanna C. Headache and migraine clinical practice guidelines: a systematic review and assessment of complementary and alternative medicine recommendations. BMC Complement Med Ther. 2021 Sep 22; 21(1): 236.

Neumeier MS, Pohl H, Sandor PS, Gut H, Merki-Feld GS, Andrée C. Dealing with Headache: Sex Differences in the Burden of Migraine- and Tension-Type Headache. Brain Sci. 2021 Oct 5; 11(10): 1323.

Zhu K, Born DW, Dilli E. Secondary Headache: Current Update. Headache. 2020 Nov;60(10): 2654–2664.

Rasmussen BK, Jensen R, Scrholl M. Epidemiology of headache in a genel population a prevelance study.J Clin Epidemiol 1991; 44: 1147–1157

Sargent DJ, Solbach P. Medical evalution of migrainosus : rewiew of the value of labarotary and radiologic tests. Headache 1983; 23: 62–65

Silberstein SD, Lipton RB, Guadsby P. In:.Clinics Practice Martin Denitz. Headache London 2002

Morgenstern LB, Huber JC, Luna-Gonzales H, Saldin KR, Grotta JC, Shaw SG, Knudson L, Frankowski RF. Headache in the emergency department Headache 2001 Jun; 41(6): 537–41. doi: 10.1046/j.1526-4610.2001.041006537.x.

Filler L, Akhter M, Nimlos P. Evaluation and Management of the Emergency Department Headache.Semin Neurol. 2019 Feb; 39(1): 20–26.

Olesen J. IHS Classification: present and future. Cephalgia 1993; 13: 94

Rasmussen BK. Epidemiology of headache. Cephalalgia 2001 Sep; 21(7): 774–7. doi: 10.1177/033310240102100708.

Raskin NH. On the origin of head pain. Headache. New York, Churchill Livingstone 1988; 28: 254–7.

Rasmussen BK, Jensen R, Scrholl M. Epidemiology of headache in a genel population a prevelance study.J Clin Epidemiol 1991; 44: 1147–1157

Blumenthal HJ, Weisz MA, Kelly KM, Mayer RL, Blonsky J. Treatment of primary headache in the emergency department. Headache Nov-Dec 2003; 43(10): 1026–31. doi: 10.1046/j.1526-4610.2003.03202.x.

Mills ML, Russo LS, Vines FS, Ross BA. High-yield criteria for urgent cranial computed tomography scans. Ann Emerg Med 1986 Oct; 15(10): 1167–72. doi: 10.1016/s0196-0644(86)80859-9.

Munoz-Ceron J, Marin-Careaga V, Peña L, Mutis J, Ortiz G. Headache at the emergency room: Etiologies, diagnostic usefulness of the ICHD 3 criteria, red and green flags. PLoS One. 2019 Jan 7; 14(1)

Rasmussen BK, Jensen R, Schroll M, Olesen J. Epidemiology of headache in a general population--a prevalence study. J Clin Epidemiol 1991; 44(11): 1147–57. doi: 10.1016/0895-4356(91)90147-2.

Beck S, Kinnear FB, Maree Kelly A, Chu KH, Sen Kuan W, Keijzers G, Body R, Karamercan MA, Klim S, Wijeratne T, Kamona S, Graham CA, Roberts T, Horner D, Laribi S; HEAD Study Group. Clinical presentation and assessment of older patients presenting with headache to emergency departments: A multicentre observational study. Australas J Ageing. 2021 Sep 27.

Wells S, Stiell IG, Vishnyakova E, Lun R, Nemnom MJ, Perry JJ. Optimal management strategies for primary headache in the emergency department. CJEM. 2021 Nov; 23(6): 802–811. doi: 10.1007/s43678-021-00173-0.

Rothrock JF, Diener HC. Headache secondary to cerebrovascular disease.Cephalalgia. 2021 Apr; 41(4): 479–492.

Lu J, Liu W, Zhao H. Headache in cerebrovascular diseases. Stroke Vasc Neurol. 2020 Jun; 5(2): 205–210.




DOI: http://dx.doi.org/10.14748/orl.v17i3.8263

Refbacks

Font Size


|