Practical management of main primary headaches in emergency care units: Neurological Institute of Curitiba Approach

Publicado na 4ª edição de 2015

Headache is the most frequent complaint in Neurology, and the principal types are the tension-type headache, and migraine. In addition to the high prevalence in the population, migraine especially has a significant impact on quality of life. It is estimated that headaches comprise 5% of all complaints in the emergency services. Migraine can be treated initially with common painkillers like intravenous dipyrone and/or non-steroid anti-inflammatory medications, followed by antidopaminergic drugs. In refractory cases, intravenous propofol can be used, and in selected cases, intravenous magnesium sulfate, corticosteroids and/or opioids may be added to therapy. For tension-type headache and undifferentiated primary headache, dipyrone, antiinflammatory and/or antidopaminergic agents are sound options. Oxygen, and then triptan and intranasal lidocaine are good options for the acute treatment of Cluster Headache.

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