Presentation of Headache in the Emergency Department and its Triage

Research output: Chapter in Book/Report/Conference proceedingChapter


Four million patients present to US emergency departments (EDs) annually with the complaint of headache. The emergency physician must diagnose malignant secondary causes of headache such as aneurysmal subarachnoid hemorrhage expeditiously, treat acute exacerbations of primary headache disorders such as migraine effectively, and provide tailored education to the primary headache patients who use the ED as a medical safety net. The needs of patients who present to EDs are varying and complex - a one-size-fits-all strategy is doomed to failure. Herein, we discuss clinical features of the various secondary headaches that emergency physicians encounter commonly; efficient diagnostic work-ups, including when to order laboratory and imaging tests; and strategies for effective parenteral and post-discharge treatment. The chapter also discusses management strategies for the complicated subgroup of ED patients with comorbid psychiatric illness, medication overuse headache, and opioid dependence who make frequent visits to an ED for management of headache.

Original languageEnglish (US)
Title of host publicationHeadache and Migraine Biology and Management
PublisherElsevier Inc.
Number of pages10
ISBN (Electronic)9780128011621
ISBN (Print)9780128009017
StatePublished - Mar 13 2015


  • Computed tomography
  • Emergency department
  • Headache
  • Opioids
  • Parenteral
  • Post-discharge care
  • Secondary headaches

ASJC Scopus subject areas

  • Health Professions(all)


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