Emergency room visit for severe headache usually justified

המידע באדיבות medicontext.co.il
Last Updated: 2001-08-06 16:24:34 EDT (Reuters Health)

WESTPORT, CT (Reuters Health) – In most cases when individuals present to the emergency department with severe headache, the visit is justified, according to researchers from the University of Texas in Houston.

In a prospective analysis, Dr. Lewis B. Morgenstern and colleagues collected data on 455 patients who presented to the Emergency Department at Hermann Hospital in Houston with a chief complaint of headache.

Twenty-eight percent of white patients were diagnosed with migraine, as were 18% of Hispanics and 10% of African Americans, the researchers report. Men were more commonly diagnosed with migraine than women were, although 76% of the total cohort was female.

Most (73%) of the patients were given some treatment for headache. Among those who received treatment, 54% received antiemetics, 23% ketorolac, 13% acetaminophen, 2% ibuprofen, 9% narcotics, 2% sumatriptan, and 0.4% ergots.

After treatment, 44% of the headaches resolved, 47% improved and 9% remained unchanged; none got worse. When a second treatment was needed, 52% resolved, 38% improved and 10% remained unchanged, with none getting worse.

Most patients were sent home, with only 10% being referred to a neurologist for followup, according to the team's report in Headache.

Dr. Morgenstern's group found that antiemetics were 3.5 times more effective in relieving headache symptoms among these patients than were medications that the patient could have taken at home. "This suggests," they advise, "that relief of head pain is better accomplished with agents that must be given in the emergency setting or similar setting."

Headache 2001;41:537-541.

-Westport Newsroom 203 319 2700

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