Yi J Zhao1, Jocelyn Y X Lim2, Pei S Wong3. 1. Department of Neurology, National Neuroscience Institute -SGH Campus, Singapore. 2. KK Women and Children's Hospital, Neurology Service, Singapore. 3. SGH Department of Pharmacy, NUS Dept of Pharmacy, Singapore.
Abstract
BACKGROUND: Headache accounts for a significant number of cases presenting to the Emergency Department (ED) and has a high societal cost, contributed by recurrent ED and clinic visits, and unnecessary diagnostic tests. OBJECTIVE: This review article covers the important clinical tools needed to evaluate headaches in both adults and children in the ED. METHODS: Medline/PubMed was searched using the keywords "Emergency department", "headache", "adult", "pediatric", "clinical assessment", "diagnosis" and "treatment", in the title or abstract. The search covers the period from 1 January 1990 to 31 December 2019. RESULTS: The articles selected were based on their relevancy to the objective of this review article. Additional relevant publications were identified from article references lists. CONCLUSION: The emergency physician plays a key role in differentiating between primary and secondary headaches. Within the limited ED resources, appropriate diagnostic testing should be used to identify the life-threatening headaches. This will ensure patients are given the appropriate evidence-based pharmacological therapy and holistic management.
BACKGROUND: Headache accounts for a significant number of cases presenting to the Emergency Department (ED) and has a high societal cost, contributed by recurrent ED and clinic visits, and unnecessary diagnostic tests. OBJECTIVE: This review article covers the important clinical tools needed to evaluate headaches in both adults and children in the ED. METHODS: Medline/PubMed was searched using the keywords "Emergency department", "headache", "adult", "pediatric", "clinical assessment", "diagnosis" and "treatment", in the title or abstract. The search covers the period from 1 January 1990 to 31 December 2019. RESULTS: The articles selected were based on their relevancy to the objective of this review article. Additional relevant publications were identified from article references lists. CONCLUSION: The emergency physician plays a key role in differentiating between primary and secondary headaches. Within the limited ED resources, appropriate diagnostic testing should be used to identify the life-threatening headaches. This will ensure patients are given the appropriate evidence-based pharmacological therapy and holistic management.