Headache Emergencies - 23/04/21

Doi : 10.1016/j.ncl.2021.01.003

David Kopel, MD ^a, Crandall Peeler, MD ^b, Shuhan Zhu, MD ^a,^⁎
^a Department of Neurology, 725 Albany Street, Suite 7B, Boston, MA 02118, USA
^b Department of Ophthalmology and Neurology, 85 East Concord Street 8th Floor, Boston, MA 02118, USA

^∗Corresponding author.

Resumen

Headache is a common reason for seeking medical attention. Most cases are benign primary headache disorders; however, there is significant overlap between symptoms of these disorders and secondary headaches. Differentiating these clinical scenarios requires a careful history with attention to red flag symptoms and a neurologic examination. These details can identify dangerous disorders: subarachnoid hemorrhage, reversible cerebral vasoconstriction syndrome, elevated intracranial pressure, hydrocephalus, cerebral venous sinus thrombosis, arterial dissection, central nervous system infection, and inflammatory vasculitis. Older, pregnant, or immunocompromised patients have a higher risk for secondary disorders; clinicians should have a different threshold to conduct evaluations in such patients.

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Keywords : Thunderclap headache, Subarachnoid hemorrhage, Elevated intracranial pressure, Intracranial hypotension, Venous sinus thrombosis, Reversible cerebral vasoconstriction syndrome, Giant cell arteritis, Papilledema

Esquema

State on conflict of interest: The authors listed have no relevant conflicts of interest related to information and topics reviewed within this article.