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Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e
Chapter 159. Headache and Facial Pain
Sections: Headache, Cranial and Facial Pain Disorders, References.
Excerpt:"Headache accounts for up to 4% of all ED visits. In
the U.S., this represents around 5 million visits each year.1–3 Migraine
headaches have prevalence rates of approximately 17% in
women and 5% in men. Most ED patients have benign primary
headache syndromes, but approximately 3.8% have serious
or secondary pathology.1For practical purposes, headaches generally are divided into primary headache
syndromes, including migraine, tension-type, and cluster
headaches, and secondary headache causes. Emergency
physicians generally are focused on identifying those patients whose
headaches are caused by life-threatening conditions. The most common
causes are listed in Table 159-1.Important features include first severe headache, worst headache
ever, steady worsening over several days, or significant differences
from prior headaches in terms of duration, severity, or associated
symptoms.3Migraine headaches are more common in women and are influenced
by hormonal factors. Menarche, menstruation, oral contraceptive
use, pregnancy, and menopause all may affect migraine. Higher estrogen
levels generally are associated with improved..."
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