Key Chapter Points
About 2–3% of all ED visits are for headache. Migraine is the #1 diagnosis for nontraumatic headache seen in the emergency department, accounting for 40–60% of all nontraumatic, emergency department headaches. While migraine sufferers usually obtain routine headache care with outpatient providers, ED treatment is generally sought when pain becomes unbearable, patient’s current headache regimen is not effective, or a patient’s primary headache provider is unavailable. ED visits are expensive and often very frustrating for staff and patients. Common errors of ED headache assessment include focusing on identifying a specific primary headache diagnosis rather than distinguishing primary from secondary headaches, misunderstanding the role of hypertension, failing to identify unreported trauma, and using treatment response to confirm a diagnosis.
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Marcus, D.A., Bain, P.A. (2012). Overview of Headache in the Emergency Department. In: Practical Assessment and Treatment of the Patient with Headaches in the Emergency Department and Urgent Care Clinic. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0002-8_1
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