Introduction: Headache is the fifth most common reason to visit an emergency department (ED). In most of the cases, headache is benign and has a primary origin, with migraine as the most common diagnosis. Inappropriate use of ED for non-emergency conditions causes overcrowding, unnecessary testing, and increased medical costs. Areas covered: All stages of headache management in ED, from the reasons to go there, the diagnosis that is made and the investigations necessary to make it, to get to the therapies administered and those prescribed at discharge, if there were any. Finally, the authors evaluated the habit of recommending medical follow-up and how often the headache is still present at discharge or returns within 24 hours. Expert Opinion: Primary headaches are underdiagnosed, misdiagnosed, and the majority do not receive drug therapy either in ED or on discharge, and in cases where the therapy is prescribed is not specific. Increase the number of primary care medical services, spread the ‘headaches culture’ among GPs and ED doctors, the adoption of ICHD in the diagnostic protocols used in EDs and a fast referral to a headache center could decrease the inappropriate use of ED and improve the headache management in the emergency units.

Evaluating and managing severe headache in the emergency department / Luciani, M.; Negro, A.; Spuntarelli, V.; Bentivegna, E.; Martelletti, P.. - In: EXPERT REVIEW OF NEUROTHERAPEUTICS. - ISSN 1473-7175. - 21:3(2021), pp. 1-26. [10.1080/14737175.2021.1863148]

Evaluating and managing severe headache in the emergency department

Luciani M.;Negro A.;Spuntarelli V.;Bentivegna E.;Martelletti P.
2021

Abstract

Introduction: Headache is the fifth most common reason to visit an emergency department (ED). In most of the cases, headache is benign and has a primary origin, with migraine as the most common diagnosis. Inappropriate use of ED for non-emergency conditions causes overcrowding, unnecessary testing, and increased medical costs. Areas covered: All stages of headache management in ED, from the reasons to go there, the diagnosis that is made and the investigations necessary to make it, to get to the therapies administered and those prescribed at discharge, if there were any. Finally, the authors evaluated the habit of recommending medical follow-up and how often the headache is still present at discharge or returns within 24 hours. Expert Opinion: Primary headaches are underdiagnosed, misdiagnosed, and the majority do not receive drug therapy either in ED or on discharge, and in cases where the therapy is prescribed is not specific. Increase the number of primary care medical services, spread the ‘headaches culture’ among GPs and ED doctors, the adoption of ICHD in the diagnostic protocols used in EDs and a fast referral to a headache center could decrease the inappropriate use of ED and improve the headache management in the emergency units.
2021
acute treatment; cluster headache; migraine treatment; primary headache; secondary headache
01 Pubblicazione su rivista::01g Articolo di rassegna (Review)
Evaluating and managing severe headache in the emergency department / Luciani, M.; Negro, A.; Spuntarelli, V.; Bentivegna, E.; Martelletti, P.. - In: EXPERT REVIEW OF NEUROTHERAPEUTICS. - ISSN 1473-7175. - 21:3(2021), pp. 1-26. [10.1080/14737175.2021.1863148]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1509344
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