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Chapter 6 - Headache

from Section 2 - Common Neurologic Presentations: A Symptom-Based Approach

Published online by Cambridge University Press:  10 January 2024

By
Sandeep Rana ,
Ye Vivian Liang ,
Paul S. Porter ,
Charles Q. Li ,
Dolores Santamaria  and
Andrea Synowiec
Edited by
Thomas P. Campbell  and
Kevin M. Kelly
Thomas P. Campbell
Affiliation:
Allegheny Health Network, Pittsburgh
Kevin M. Kelly
Affiliation:
Allegheny Health Network, Pittsburgh
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Summary

Headache as a presenting symptom is commonly encountered by the emergency department (ED) physician. The differential diagnosis of headaches is extensive and the etiologies can range from benign to life-threatening. These patients can pose a diagnostic and therapeutic challenge to the treating clinician. This chapter encapsulates the clinical approach, appropriate evaluation, and treatment options in patients presenting with the complaint of headache.

Keywords

headachemigraineclustervasculitisidiopathic intracranial hypertensionsubarachnoid hemorrhage
Type
Chapter
Information
Handbook of Emergency Neurology , pp. 70 - 83
Publisher: Cambridge University Press
Print publication year: 2023

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References

Anthony, M, Daher, BN. Mechanism of action of steroids in cluster headache. In Clifford, RF (ed.) New Advances in Headache Research 2. Smith Gordon, 1992.Google Scholar
Backes, D, Rinkel, GJ, Kemperman, H, Linn, FH, Vergouwen, MD. Time-dependent test characteristics of head computed tomography in patients suspected of nontraumatic subarachnoid hemorrhage. Stroke 2012;43(8):2115–2119.CrossRefGoogle ScholarPubMed
Barton, CW Evaluation and treatment of headache patients in the emergency department: a survey. Headache 1994;34:91–94.CrossRefGoogle ScholarPubMed
Bigal, ME, Bordini, CA, Tepper, SJ, Speciali, JG. Intravenous magnesium sulphate in the acute treatment of migraine without aura and migraine with aura: a randomized double-blind placebo-controlled study. Cephalalgia 2002;22(5):345–353.Google Scholar
Bigal, ME, Bordini, CA, Speciali, JG. Intravenous chlorpromazine in the emergency department treatment of migraines: a randomized controlled trial. J Emerg Med 2002;23(2):141–148.CrossRefGoogle ScholarPubMed
Bigal, ME, Lipton, RB. Excessive opioid use and the development of chronic migraine. Pain 2009;142(3):179–182.CrossRefGoogle ScholarPubMed
Cete, Y, Dora, B, Ertan, C, Ozdemir, C, Oktay, C. A randomized prospective placebo-controlled study of intravenous magnesium sulphate vs. metoclopramide in the management of acute migraine attacks in the Emergency Department. Cephalalgia 2005;25(3):199–204.Google Scholar
Demirkaya, S, Vural, O, Dora, B, Topcuoglu, MA. Efficacy of intravenous magnesium sulfate in the treatment of acute migraine attacks. Headache 2001;41(2):171–177.CrossRefGoogle ScholarPubMed
Dodick, DW, Capobianco, DJ. Treatment and management of cluster headache. Curr Pain Headache Rep 2001;5:83–91.Google Scholar
Dougherty, CO, Marmura, MJ, Ergonul, Z, Charleston, LC, Szperka, CL. Emergency and inpatient treatment of migraine: an American Headache Society survey. Brit J Med Med Res 2014;4(20):3800–3813.Google Scholar
Ekbom, K Treatment of acute cluster headache with sumatriptan. N Engl J Med 1991;325:322–326.Google Scholar
Fogan, L Treatment of cluster headache: a double-blind comparison of oxygen vs air inhalation. Arch Neurol 1985;42:362–363.Google Scholar
Frank, LR, Olson, CM, Shuler, KB, Gharib, SF. Intravenous magnesium for acute benign headache in the emergency department: a randomized double-blind placebo-controlled trial. CJEM 2004;6(5):327–332.Google Scholar
Ginder, S, Oatman, B, Pollack, M. A prospective study of i.v. magnesium and i.v. prochlorperazine in the treatment of headaches. J Emerg Med 2000;18(3):311–315.CrossRefGoogle ScholarPubMed
Grosberg, BM, Solomon, S Recognition and treatment of cluster headache in the emergency department. Curr Pain Headache Rep 2004;8:140–146.Google Scholar
Kostic, MA, Gutierrez, FJ, Rieg, TS, Moore, TS, Gendron, RT. A prospective, randomized trial of intravenous prochlorperazine versus subcutaneous sumatriptan in acute migraine therapy in the emergency department. Ann Emerg Med 2010;56(1):1–6.Google Scholar
Orr, SL, Aube, M, Becker, WJ, et al. Canadian Headache Society systematic review and recommendations on the treatment of migraine pain in emergency settings. Cephalalgia 2014;35(3):271–284.Google Scholar
Raskin, NH. Repetitive intravenous dihydroergotamine as therapy for intractable migraine. Neurology. 1986;36:995–997.Google Scholar
Saper, JR, Silberstein, SD, Gordon, CD, Hamel, RL (eds.). Handbook of Headache Management. Williams & Wilkins, 1993.Google Scholar
Saper, JR, Lake III, AE. Continuous opioid therapy (COT) is rarely advisable for refractory chronic daily headache: limited efficacy, risks, and proposed guidelines. Headache 2008;48(6):838–849.Google Scholar
Schwartz, TH, Karpitskiy, VV, Sohn, RS. Intravenous valproate sodium in the treatment of daily headache. Headache 2002;42(6):519–522.CrossRefGoogle ScholarPubMed
Somerville, BW. Treatment of migraine attacks with an analgesic combination (Mersyndol). Med J Aust 1976;1(23):865–866.Google Scholar
Swidan, SZ, Lake III, AE, Saper, JR. Efficacy of intravenous diphenhydramine versus intravenous DHE-45 in the treatment of severe migraine headache. Curr Pain Headache Rep 2005;9(1):65–70.Google Scholar

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