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ACUTE HEADACHE

ACUTE HEADACHE . “ Critical issues in the evaluation and management of patients presenting to the emergency department with acute headache ” - Annals of Emergency Medicine, jan 2002. Focuses on 4 areas of current interest and / or controversy in acute headache management .

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ACUTE HEADACHE

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  1. ACUTE HEADACHE

  2. “Criticalissues in theevaluationand management ofpatientspresenting to theemergencydepartmentwithacuteheadache” - AnnalsofEmergency Medicine, jan 2002

  3. Focuseson 4 areasofcurrentinterestand/orcontroversy in acuteheadache management.

  4. Does a response to therapypredicttheetiologyof na acuteheadache? - Painresponse to therapyshouldnotbeused as the sole diagnosticindicatoroftheunderlyingetiologyof na acuteheadache. - Level C recommendations

  5. In whichadultpatientswith a complaintofheadachecan a lumbarpuncturebesafelyperformedwithout a neuroimagingstudy? - Adultpatientswithheadacheexhibitingsignsofincreasedintracranialpressureincludingpapiledema, absentvenouspulsationsonfundoscopicexamination, altered mental status, or focal neurologicdeficitsshouldundergo a neuroimagingstudybeforehaving na LP. - Level C recommendations

  6. Whichpatientswithheadacherequireneuroimaging in the ED? - Patientspresenting to the ED withheadacheand abnormal findings in a neurologicexamination (ie, focal deficit, altered mental status, alteredcognitivefunction) shouldundergoemergentnoncontrasthead CT scan. Patientspresentingwithacutesudden-onsetheadacheshouldbeconsidered for na emergenthead CT scan. - Level B recommendations

  7. - Patientswho are olderthan 50 yearspresentingwithnewtypeofheadachewithout abnormal findings in a neurologicexaminationshouldbeconsidered for na urgentneuroimagingstudy. - Level C recommendations

  8. Is there a need for emergentangiography in thepatientwith a “thunderclapheadache” whohasnegativefindings in CT and LP? - Patientswith a thunderclapheadachewhohavenegativefindings in a head CT scan, normal openingpressure, andnegativefindings in CSF analysis do notneedemergentangiographyandcanbedischargedfromthe ED with follow-up arrangedwiththeirprimarycareproviderorneurologist. - Level C recommendations

  9. Obrigado!!!

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