Epidemiology of headache in a neurological Emergency Department in Medellin, Colombia
DOI:
https://doi.org/10.48208/HeadacheMed.2023.9Keywords:
Headache, Emergency department, Epidemiology, NeuroimagingAbstract
Introduction
Headache is a common reason for presentation to emergency departments (ED) around the world. In many countries, ED are not speciality-focussed, however, in Colombia and some other countries, specialist neurological hospitals have ED with a strong neurological focus. For patients presenting with headache, these ED may have different epidemiology, investigation strategies and treatment patterns from general ED. The objective of this study was to describe the epidemiology of headache presenting to the ED of Instituto Neurológico de Colombia in Medellin, Colombia – an ED which is a referral centre for neurological and neurosurgical diseases.
Methods
This was an observational study by chart review of adults (aged ≥18) with a main presenting compliant of headache. Demographic, clinical, imaging, diagnoses and outcome data were collected. The primary outcome of interest was the rate of serious secondary intracranial headache cause. Analysis was descriptive.
Conclusion
Diagnosis of headache in ED is challenging with a very wide range of possible causes. A small proportion of patients (approx. 9%) have a serious cause for their symptoms – a proportion similar to that reported in other international emergency department cohorts.
Downloads
References
Kelly AM, Kuan WS, Chu Kevin H, Kinnear FB, Keijzers G, Karamercan MA, . . . Russell K. Epidemiology, investigation, management, and outcome of headache in emergency departments (HEAD study)—A multinational observational study. Headache: The Journal of Head and Face Pain 2021;61(10):1539-1552 Doi: 10.1111/head.14230 DOI: https://doi.org/10.1111/head.14230
Chu KH, Howell TE, Keijzers G, Furyk JS, Eley RM, Kinnear FB, . . . Brown AF. Acute Headache Presentations to the Emergency Department: A Statewide Cross-sectional Study. Acad Emerg Med 2017;24(1):53-62 Doi: 10.1111/acem.13062 DOI: https://doi.org/10.1111/acem.13062
National Center for Health Statistics. Ambulatory Health Care Data, 2017. Available from: https://www.cdc.gov/nchs/ahcd/new_ahcd.htm. Accessed December 11, 2020.
Doretti A, Shestaritc I, Ungaro D, Lee JI, Lymperopoulos L, Kokoti L, . . . School of Advanced Studies of the European Headache F. Headaches in the emergency department -a survey of patients' characteristics, facts and needs. J Headache Pain 2019;20(1):100 Doi: 10.1186/s10194-019-1053-5 DOI: https://doi.org/10.1186/s10194-019-1053-5
Granato A, Morelli ME, Cominotto F, D'Acunto L and Manganotti P. Adherence to guidelines of treatment of non-traumatic headache in the emergency department. Acta Neurol Belg 2020;120(1):19-24 Doi: 10.1007/s13760-020-01272-y DOI: https://doi.org/10.1007/s13760-020-01272-y
May A. Hints on Diagnosing and Treating Headache. Dtsch Arztebl Int 2018;115(17):299-308 Doi: 10.3238/arztebl.2018.0299 DOI: https://doi.org/10.3238/arztebl.2018.0299
Filler L, Akhter M and Nimlos P. Evaluation and Management of the Emergency Department Headache. Semin Neurol 2019;39(1):20-26 Doi: 10.1055/s-0038-1677023 DOI: https://doi.org/10.1055/s-0038-1677023
Yang S, Orlova Y, Lipe A, Boren M, Hincapie-Castillo JM, Park H, . . . Lo-Ciganic WH. Trends in the Management of Headache Disorders in US Emergency Departments: Analysis of 2007-2018 National Hospital Ambulatory Medical Care Survey Data. J Clin Med 2022;11(5):Doi: 10.3390/jcm11051401 DOI: https://doi.org/10.3390/jcm11051401
Goldstein JN, Camargo CA, Jr., Pelletier AJ and Edlow JA. Headache in United States emergency departments: demographics, work-up and frequency of pathological diagnoses. Cephalalgia 2006;26(6):684-690 Doi: 10.1111/j.1468-2982.2006.01093.x DOI: https://doi.org/10.1111/j.1468-2982.2006.01093.x
Raam R and Tabatabai RR. Headache in the Emergency Department: Avoiding Misdiagnosis of Dangerous Secondary Causes, An Update. Emerg Med Clin North Am 2021;39(1):67-85 Doi: 10.1016/j.emc.2020.09.004 DOI: https://doi.org/10.1016/j.emc.2020.09.004
Prevedello LM, Raja AS, Zane RD, Sodickson A, Lipsitz S, Schneider L, . . . Khorasani R. Variation in use of head computed tomography by emergency physicians. Am J Med 2012;125(4):356-364 Doi: 10.1016/j.amjmed.2011.06.023 DOI: https://doi.org/10.1016/j.amjmed.2011.06.023
Heetderks-Fong E. Appropriateness Criteria for Neuroimaging of Adult Headache Patients in the Emergency Department: How Are We Doing? Adv Emerg Nurs J 2019;41(2):172-182 Doi: 10.1097/TME.0000000000000240 DOI: https://doi.org/10.1097/TME.0000000000000240
Do TP, Remmers A, Schytz HW, Schankin C, Nelson SE, Obermann M, . . . Schoonman GG. Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list. Neurology 2019;92(3):134-144 Doi: 10.1212/WNL.0000000000006697 DOI: https://doi.org/10.1212/WNL.0000000000006697
Ta R and Blond BN. The prevalence of and contributors to neurocysticercosis in endemic regions. J Neurol Sci 2022;441(120393 Doi: 10.1016/j.jns.2022.120393 DOI: https://doi.org/10.1016/j.jns.2022.120393
Krymchantowski A, Jevoux C, Silva-Neto RP and Krymchantowski AG. Migraine Treatment in Emergency Departments of Brazil: A Retrospective Study of 2 Regions. Headache 2020;60(10):2413-2420 Doi: 10.1111/head.13999 DOI: https://doi.org/10.1111/head.13999
Robblee J and Grimsrud KW. Emergency Department and Inpatient Management of Headache in Adults. Curr Neurol Neurosci Rep 2020;20(4):7 Doi: 10.1007/s11910-020-01030-w DOI: https://doi.org/10.1007/s11910-020-01030-w
Singh A, Alter HJ and Zaia B. Does the addition of dexamethasone to standard therapy for acute migraine headache decrease the incidence of recurrent headache for patients treated in the emergency department? A meta-analysis and systematic review of the literature. Acad Emerg Med 2008;15(12):1223-1233 Doi: 10.1111/j.1553-2712.2008.00283.x DOI: https://doi.org/10.1111/j.1553-2712.2008.00283.x
Woldeamanuel YW, Rapoport AM and Cowan RP. The place of corticosteroids in migraine attack management: A 65-year systematic review with pooled analysis and critical appraisal. Cephalalgia 2015;35(11):996-1024 Doi: 10.1177/0333102414566200 DOI: https://doi.org/10.1177/0333102414566200
Munoz-Ceron J, Marin-Careaga V, Pena L, Mutis J and Ortiz G. Headache at the emergency room: Etiologies, diagnostic usefulness of the ICHD 3 criteria, red and green flags. PLoS One 2019;14(1):e0208728 Doi: 10.1371/journal.pone.0208728 DOI: https://doi.org/10.1371/journal.pone.0208728
Genc H, Baykan B, Bolay H, Uluduz D, Unal-Cevik I, Kissani N, . . . Head Msg. Cross-sectional, hospital-based analysis of headache types using ICHD-3 criteria in the Middle East, Asia, and Africa: the Head-MENAA study. J Headache Pain 2023;24(1):24 Doi: 10.1186/s10194-023-01555-8 DOI: https://doi.org/10.1186/s10194-023-01555-8
Gilbert EH, Lowenstein SR, Koziol-McLain J, Barta DC and Steiner J. Chart reviews in emergency medicine research: Where are the methods? Ann Emerg Med 1996;27(3):305-308 Doi: 10.1016/s0196-0644(96)70264-0 DOI: https://doi.org/10.1016/S0196-0644(96)70264-0
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Anne-Maree Kelly, Alejandro Cardozo, Valentina Jaramillo , Paola Parra (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.