Evaluation and management of headache in the emergency department

Patients presenting to the emergency department (ED) with a chief complaint of headache are common, representing 2% or more of all ED visits, Headache as a symptom in ED patients is more common because headache accompanies many systemic illnesses. Although there are perhaps several hundred illnesses that may occur with headache as a significant feature, the presence of this symptom may be considered a useful clue to the underlying problems. In the evaluation of these patients, there is no substitute for a thorough, efficient approach, especially because most of these patients are not known to the ED personnel. Using a systematic approach enables the physician to arrive at the diagnosis reliably and to alleviate suffering more rapidly.