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Diagnoses and Management of Acute Headache in the Emergency Department William B. Halacoglu, DO., FACOEP Department o

Case I: 40 yo. F-brought to the ER by EMS, c/o severe HA. Describes HA as pounding in nature, diffuse, sudden onset, associated with N/V X 3 over the last several hours. Also c/o dizziness

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Diagnoses and Management of Acute Headache in the Emergency Department William B. Halacoglu, DO., FACOEP Department o

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    1. Diagnoses and Management of Acute Headache in the Emergency Department William B. Halacoglu, DO., FACOEP Department of Emergency Medicine Mount Clemens Regional Medical Center

    4. Headache Is a Major Public Health Problem . Up to 4% of ED Visits / 2% All Office Visits . Over 20 Million Outpatient Visits . 78 % of Women and 60% of Men Experienced at Least One Headache in the Year . 36% of Women and 19% Men Suffered From Recurrent Headaches

    5. Potentially Life Threatening Etiologies Characterize Patients Presenting to the Emergency Department With a Chief Complaint of a Severe Headache in <5% of the Cases

    6. Goals of Headache Management in the Emergency Department Primary Exclude Ominous Causes Provide Adequate Relief of Pain Secondary Minimize Time Spent in the ED Establish Continuity of Care after discharge

    16. Secondary Headaches Subarachnoid Hemorrhage Meningitis Temporal Arteritis Hypertension Glaucoma Trauma Non-meningitic Infections Pseudotumor Cerebri Metabolic Disorders Toxic Substances Space Occupying Lesions Sinusitis

    20. Primary Headache Etiology ????

    21. Primary Headache Pathophysiology Hypotheses (specific cause unknown) -Cortical spreading definition -Migraine generator -Vasodilation/inflammation -Peripheral sensitization -Genetic factors -Others….

    22. International Headache Society Criteria for Migraine Migraine Is an Episodic Recurrent HA lasting 4-72 Hours With: Any 2 of these pain qualities: . Unilateral pain . Throbbing pain . Pain worsened by movement . Moderate or severe pain Any 1 of these associated symptoms: .Neusea and/or vomiting .Photophobia and phonophobia

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