Diagnosis and Management of Headaches in the Emergency Department (ED) in Adults and Children

Background: Headache accounts for a significant number of cases presenting to the Emergency Department (ED) and has a high societal cost, contributed by recurrent ED and clinic visits, and unnecessary diagnostic tests. Objective: This review article covers the important clinical tools needed to evaluate headaches in both adults and children in the ED. Methods: Medline/PubMed was searched using the keywords "Emergency department", "headache", "adult", "pediatric", "clinical assessment", "diagnosis" and "treatment", in the title or abstract. The search covers the period from 1 January 1990 to 31 December 2019. Results: The articles selected were based on their relevancy to the objective of this review article. Additional relevant publications were identified from article references lists. Conclusion: The emergency physician plays a key role in differentiating between primary and secondary headaches. Within the limited ED resources, appropriate diagnostic testing should be used to identify the life-threatening headaches. This will ensure patients are given the appropriate evidence-based pharmacological therapy and holistic management.