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Headache
Aka: Headache, Cephalgia- See Also
- Migraine Headache
- Tension Headache
- Headache History
- Headache Examination
- Headache Red Flags
- Acute Headache
- Chronic Headache
- Epidemiology
- Incidence
- ER Visits in U.S annually: 3 Million (15% of all ER Visits)
- Secondary Headaches (e.g. Subarachnoid Hemorrhage, Meningitis) represent 2% of cases
- Costs
- Cost due to lost work per year US: $5-17 Billion
- Incidence
- Precautions
- See Headache Red Flag
- Relieving acute Headache pain does not obviate the need to distinguish primary from Secondary Headache
- Discerning Secondary Headache is critical in the Headache Evaluation
- Although <2% of acute Headaches, missing Secondary Headache can have devastating consequences
- Findings
- Diagnostics
- Differential Diagnosis
- See Headache Causes
- Primary Headache (98% of Headaches in the Emergency Department)
- Migraine Headache (80% are without aura)
- Cluster Headache
- Tension Headache
- Secondary Headache (important selected causes)
- See Headache Red Flag
- Localized Headache
- Temporal Arteritis (temporal pain in over age 50 years)
- Acute Angle-Closure Glaucoma (severe Eye Pain)
- Fever
- Exposure related
- Carbon Monoxide Poisoning (typically furnace in winter)
- Post-Traumatic Headache (post-Concussion Headache)
- Young Women
- Thunderclap Headaches (severe sudden-onset)
- Subarachnoid Hemorrhage
- Cervical Artery Dissection (carotid dissection, Vertebrobasilar Dissection)
- Venous sinus thrombosis
- Pituitary apoplexy
- Anatomic neurologic deficits
- Trauma
- Acute or chronic Subdural Hematoma
- Other common benign Secondary Headaches
- Evaluation
- Management
- See Headache General Measures
- Management directed at specific Headache type
- Resources
- National Headache Foundation
- References
- Cutrer in Goldman (2000) Cecil Medicine, p. 2066
- Henry in Marx (2002) Rosen's Emergency Medicine, p. 152
- Pruitt in Goroll (2000) Primary Care Medicine, p. 931-9
- Clinch (2001) Am Fam Physician 63(4):685-92 [PubMed]
- Coutin (1996) Am Fam Physician 54(7):2247-52 [PubMed]
- Saper (1999) Med Clin North Am 83(3):663-90 [PubMed]