title: Evaluation and treatment of headache patients in the emergency department: a survey.
abstract: Patients with headache represent a common diagnostic and treatment challenge for health care providers in the emergency department. The therapeutic options continue to grow, yet many studies imply that narcotics continue to be a frequently chosen treatment. In this retrospective cross-sectional survey, the evaluation and treatment patterns of patients presenting to an academic medical center emergency department with a primary diagnosis of headache were analyzed. Headache disorders accounted for 1.7% of all visits to the emergency department. Migraine headache was the most common headache diagnosis representing 60% of headache visits followed by headache of no obvious source at 25%. Narcotics were the most common treatment employed (180 patient-visits) in all patients and non-steroidal anti-inflammatory agents were the second most common agent used (86 patient visits). Narcotics were also the most common therapy in migraine headache patients (152 patient-visits) while ergotamines were used in less than one-third of patient-visits (36 patient-visits). Therapy of headache patients in the emergency department continues to rely on narcotics. Methods of interrupting the dependence on narcotics need to be explored if newer non-narcotic therapies are to be successful.
authors.affiliation: Department of Medicine, Medical Center, University of California, San Francisco 94143-0208.
authors.forename: C W
authors.initials: CW
authors.lastname: Barton
mesh_terms: D000328:Adult; D003625:Data Collection; D004632:Emergency Medical Services; D005260:Female; D006261:Headache / Q000175:diagnosis* / Q000628:therapy*; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D012189:Retrospective Studies