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Headaches, neurologists and the emergency department.

Authors
  • Gaughran, C G
  • Tubridy, N
Type
Published Article
Journal
Irish medical journal
Publication Date
Jun 01, 2014
Volume
107
Issue
6
Pages
168–171
Identifiers
PMID: 24988831
Source
Medline
License
Unknown

Abstract

This study explores the claim that headache management can be improved by evaluating current emergent care. A retrospective chart review investigated primary complaints of headache during a three-month period. Two hundred and twenty seven patients were identified for review and three-month follow-up using fully available records and imaging. A total of 543/8,759 had a neurological condition. The most common conditions were headaches (42% or 227 cases), cerebrovascular problems (26%) and seizures (17%). No 'usual headache' patterns showed abnormal imaging. In contrast, those with 'sudden-onset' type or clinical findings had an abnormal scan 17% of the time. Of the MRIs ordered, one-quarter changed management. On discharge, 39% of patients left without a specific headache diagnosis. In the discussion, we evaluate how well a tertiary referral ED treats its most common neurological complaint, focusing on the controversial topics of when to investigate and prevention of re-attendance.

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