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
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
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.