What Proportion of Emergency Department Headache Patients With Normal Neurology Have a Serious Secondary Headache Cause? A HEAD Study Report.

OBJECTIVES

To estimate the proportion of Emergency Department (ED) headache patients without neurological features who are diagnosed with a serious secondary headache cause.

METHODS

Unplanned secondary analysis of HEAD Study/HEAD Colombia data. Patients without a known history of cerebral conditions and with a normal neurological assessment were included. The outcome of interest was the proportion of patients diagnosed with a serious secondary headache cause.

RESULTS

One hundred ninety-one patients were diagnosed with a serious secondary headache cause (191/3951, 4.8%, 95% CI 4.2%-5.5%).

CONCLUSION

Absence of neurological features alone cannot be used to reliably exclude a serious secondary headache cause in ED patients.