What Proportion of Emergency Department Headache Patients With Normal Neurology Have a Serious Secondary Headache Cause? A HEAD Study Report
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Chu, Kevin H
Kuan, Win Sen
Keijzers, Gerben
Kinnear, Frances B
Cardozo-Ocampo, Alejandro
HEAD Study and HEAD Colombia Investigators
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Abstract
Objectives To estimate the proportion of Emergency Department (ED) headache patients without neurological features who are diagnosed with a serious secondary headache cause.
Methods Unplanned secondary analysis of HEAD Study/HEAD Colombia data. Patients without a known history of cerebral conditions and with a normal neurological assessment were included. The outcome of interest was the proportion of patients diagnosed with a serious secondary headache cause.
Results One hundred ninety-one patients were diagnosed with a serious secondary headache cause (191/3951, 4.8%, 95% CI 4.2%–5.5%).
Conclusion Absence of neurological features alone cannot be used to reliably exclude a serious secondary headache cause in ED patients.
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Emergency Medicine Australasia
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37
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5
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© 2025 The Author(s). Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
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Emergency medicine
Neurology and neuromuscular diseases
Clinical sciences
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Kelly, AM; Chu, KH; Kuan, WS; Keijzers, G; Kinnear, FB; Cardozo-Ocampo, A; HEAD Study and HEAD Colombia Investigators, What Proportion of Emergency Department Headache Patients With Normal Neurology Have a Serious Secondary Headache Cause? A HEAD Study Report, Emergency Medicine Australasia, 2025, 37 (5), pp. e70138