Clinical policy: Critical issues in the evaluation and management of adult patients presenting to the emergency department with acute headache

This clinical Policy from the American College of Emergency physicians is all Update of a 2002 clinical policy on the evaluation and management of adult patients presenting to the emergency department (ED) with acute, nontraumatic huadache. A writing subcummittee reviewed the literature to derive evidence-bascd recommendations to help clinicians answer the following 5 critical questions: (1) Does I response to therapy predict the etiology of all acute headache (2) Which patients with headache require neuroimaging in the ED? (3) Does lumbar puncture need to be routinely performed oil ED patients being worked LIP for nontraumatic subarachnoid hemorrhage whose noncontrast brain computed tomography (CT) scans are interpreted as normal? (4) In which adult patients with a complaint of headache call a lumbar puncture be safely performed without a neuroimaging study? (5) Is there a need for further emergent diagnostic imaging in the patient With sudden-onset, Severe headache who has negative findings In both CT and lumbar puncture? Evidence was graded and recommendations were given based on the Strength of the available data in File medical literature.