Headache in the Emergency Department: Avoiding Misdiagnosis of Dangerous Secondary Causes, An Update

Ryan Raam; Ramin R Tabatabai

doi:10.1016/j.emc.2020.09.004

Headache in the Emergency Department: Avoiding Misdiagnosis of Dangerous Secondary Causes, An Update

Emerg Med Clin North Am. 2021 Feb;39(1):67-85. doi: 10.1016/j.emc.2020.09.004.

Authors

Ryan Raam¹, Ramin R Tabatabai²

Affiliations

¹ Keck School of Medicine of USC, LAC+USC Emergency Medicine Residency, 1200 North State Street #1011, Los Angeles, CA 90033, USA. Electronic address: ryan.raam@med.usc.edu.
² Keck School of Medicine of USC, LAC+USC Emergency Medicine Residency, 1200 North State Street #1011, Los Angeles, CA 90033, USA.

PMID: 33218663
DOI: 10.1016/j.emc.2020.09.004

Abstract

In the initial assessment of the headache patient, the emergency physician must consider several dangerous secondary causes of headache. A thorough history and physical examination, along with consideration of a comprehensive differential diagnosis may alert the emergency physician to the diagnosis of a secondary headache particularly when the history is accompanied by any of the following clinical features: sudden/severe onset, focal neurologic deficits, altered mental status, advanced age, active or recent pregnancy, coagulopathy, malignancy, fever, visual deficits, and/or loss of consciousness.

Keywords: Emergency medicine; Misdiagnosis; Secondary headaches.

Publication types

Review

MeSH terms

Diagnosis, Differential
Diagnostic Errors / prevention & control
Emergency Service, Hospital*
Headache / diagnosis*
Headache / etiology
Humans
Subarachnoid Hemorrhage / complications
Subarachnoid Hemorrhage / diagnosis