Headache in the Emergency Department: Avoiding Misdiagnosis of Dangerous Secondary Causes

Ramin R Tabatabai; Stuart P Swadron

doi:10.1016/j.emc.2016.06.003

Headache in the Emergency Department: Avoiding Misdiagnosis of Dangerous Secondary Causes

Emerg Med Clin North Am. 2016 Nov;34(4):695-716. doi: 10.1016/j.emc.2016.06.003. Epub 2016 Sep 3.

Authors

Ramin R Tabatabai¹, Stuart P Swadron²

Affiliations

¹ LAC+USC Emergency Medicine Residency, LAC+USC Medical Center, Keck School of Medicine of USC, 1200 North State Street, Room 1060E, Los Angeles, CA 90033, USA. Electronic address: tabatabai.usc@gmail.com.
² LAC+USC Emergency Medicine Residency, LAC+USC Medical Center, Keck School of Medicine of USC, 1200 North State Street, Room 1060E, Los Angeles, CA 90033, USA.

PMID: 27741984
DOI: 10.1016/j.emc.2016.06.003

Abstract

There are a number of dangerous secondary causes of headaches that are life, limb, brain, or vision threatening that emergency physicians must consider in patients presenting with acute headache. Careful history and physical examination targeted at these important secondary causes of headache will help to avoid misdiagnosis in these patients. Patients with acute thunderclap headache have a differential diagnosis beyond subarachnoid hemorrhage. Considering the "context" of headache "PLUS" some other symptom or sign is one strategy to help focus the differential diagnosis.

Keywords: Headache misdiagnosis; Primary headache; Secondary headache; Thunderclap headache.

Publication types

Review

MeSH terms

Central Nervous System Diseases / complications
Cognition Disorders / diagnosis
Cognition Disorders / etiology
Diagnostic Errors / prevention & control*
Emergency Service, Hospital*
Fever / complications
HIV Infections / complications
Headache / diagnosis*
Headache / etiology
Humans
Neoplasms / complications