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Diagnosis and therapeutic management of primary headache in an emergency setting

  • Autori: Camarda, C; Biondo, V; Sanna, F; Monastero, R; Russo, M; Manzoni, GC; Torelli, P
  • Anno di pubblicazione: 2013
  • Tipologia: Proceedings (TIPOLOGIA NON ATTIVA)
  • Parole Chiave: Introduction and aim: Much headachers are under or mis-diagnoses and data regarding the proportion of patients attending an emergency department (ED) because of headache are still few. We conducted a retrospective, observational study in an ED with the following aims: (a) estimate the proportion of headache attending to an ED, (b) to estimate and describe the therapeutic management of primary headache and (c) to assessment the exam most frequently requested. Materials and methods: We collected data regarding patients diagnosed with headache consecutively attending the ED, of the University of Palermo, between September 2011 and March 2012. The study was approved by the ethics committee. Results: Between the semester evaluated, 25,110 subjects were admitted to ED, headache suffers were equal to 1.6 %. Of these 263 (63.1 %) were woman and 154 (36.9 %). Mean age was 44.2 (DS ± 18.4) years (p = 0.068).According to ED registry, headache admission was as follow assigned: 76.5 % with a diagnosis of headache, 22.8 % with a secondary headache, 0.7 % with Trigeminal Autonomic Cephalgias (TACs). Among those with a primary headache about 36 % of patient did not received a pharmacological treatment. Monotherapy was prescribed less frequently than combination therapy (19.1 vs 44.5 %).In monotherapy the most frequent medication were NSAIDs (28.3 %), benzodiazepines (26.7 %) and dopamine antagonists (11.7 %). Among those with a primary headache a CT scan was performed in the 124 subjects and 111 (34.8 %) had a neurologist consultation. Discussion: Our data are in line with the one previously reported in literature. The most frequently medication in the Italian ED were NSAIDs, benzodiazepines, dopamine antagonists and steroids. Neverless our data unlikely can be compared to other study give a snapshot. We believe that much more can be done to improve treatment of primary headache in ED.
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