Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-669899f699-swprf Total loading time: 0 Render date: 2025-04-30T21:08:34.824Z Has data issue: false hasContentIssue false

2 - Epidemiology of Headache in the Emergency Department

Published online by Cambridge University Press:  09 October 2017

By
Serena L. Orr  and
David W. Dodick
Edited by
Serena L. Orr ,
Benjamin W. Friedman  and
David W. Dodick
Serena L. Orr
Affiliation:
Children’s Hospital of Eastern Ontario, Ottawa
Benjamin W. Friedman
Affiliation:
Albert Einstein College of Medicine, New York
David W. Dodick
Affiliation:
Mayo Clinic, Phoenix, AZ
Get access

Summary

Abstract

Headache is one of the most common chief complaints in the emergency department (ED). Several demographic and other factors are associated with the propensity to visit the ED with headache. Whereas primary headaches are the most common cause of headache in the adult ED, secondary, non-life-threatening causes, such as headaches associated with viral illnesses, underlie most headaches in the pediatric ED. Costs associated with ED headache visits are high, partly due to the rising use of neuroimaging in this patient population. Several strategies could help to mitigate the cost of headache care in the ED, primarily by aiming to improve community-based care for patients with primary headaches. In this chapter, a detailed overview of the epidemiology of headache in the ED is provided.

Type
Chapter
Information
Emergency Headache
Diagnosis and Management
 , pp. 4 - 14
Publisher: Cambridge University Press
Print publication year: 2017

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

1.Lucado, J, Paez, K, Elixhauser, A. Headaches in US Hospitals and Emergency Departments, 2008: Statistical Brief #111. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. 2011;24:1–12.Google Scholar
2.Barton, CW. Evaluation and treatment of headache patients in the emergency department: a survey. Headache. 1994;34(2):91–4.CrossRefGoogle ScholarPubMed
3.Smitherman, TA, Burch, R, Sheikh, H, Loder, E. The prevalence, impact, and treatment of migraine and severe headaches in the United States: a review of statistics from national surveillance studies. Headache. 2013;53(3):427–36.CrossRefGoogle ScholarPubMed
4.Dermitzakis, EV, Georgiadis, G, Rudolf, J, et al. Headache patients in the emergency department of a Greek tertiary care hospital. J Headache Pain. 2010;11(2):123–8.CrossRefGoogle ScholarPubMed
5.Fodden, D, Peatfield, R, Milsom, P. Beware the patient with a headache in the accident and emergency department. Emerg Med J. 1989;6(1):7–12.CrossRefGoogle ScholarPubMed
6.De Carli, GF, Fabbri, L, Cavazzuti, L, et al. The epidemiology of migraine: a retrospective study in Italian emergency departments. Headache. 1998;38(9):697–704.CrossRefGoogle Scholar
7.Cerbo, R, Villani, V, Bruti, G, Di, SF, Mostardini, C. Primary headache in emergency department: prevalence, clinical features and therapeutical approach. J Headache Pain. 2005;6(4):287–9.CrossRefGoogle ScholarPubMed
8.Bigal, ME, Bordini, CA, Speciali, JG. Etiology and distribution of headaches in two Brazilian primary care units. Headache. 2000;40(3):241–7.CrossRefGoogle ScholarPubMed
9.Maizels, M. Health resource utilization of the emergency department headache “repeater.” Headache. 2002;42(8):747–53.CrossRefGoogle ScholarPubMed
10.Szyszkowicz, M, Kaplan, GG, Grafstein, E, Rowe, BH. Emergency department visits for migraine and headache: a multi-city study. Int J Occup Med Environ Health. 2009;22(3):235–42.CrossRefGoogle ScholarPubMed
11.Szyszkowicz, M, Rowe, BH, Kaplan, GG. Ambient sulphur dioxide exposure and emergency department visits for migraine in Vancouver, Canada. Int J Occup Med Environ Health. 2009;22(1):7–12.CrossRefGoogle ScholarPubMed
12.Szyszkowicz, M, Stieb, DM, Rowe, BH. Air pollution and daily ED visits for migraine and headache in Edmonton, Canada. Am J Emerg Med. 2009;27(4):391–6.CrossRefGoogle ScholarPubMed
13.Szyszkowicz, M. Ambient air pollution and daily emergency department visits for headache in Ottawa, Canada. Headache. 2008;48(7):1076–81.Google ScholarPubMed
14.Caperell, K, Pitetti, R. Seasonal variation of presentation for headache in a pediatric emergency department. Pediatr Emerg Care. 2014;30(3):174–6.CrossRefGoogle Scholar
15.Kedia, S, Ginde, AA, Grubenhoff, JA, et al. Monthly variation of United States pediatric headache emergency department visits. Cephalalgia. 2014;34(6):473–8.CrossRefGoogle ScholarPubMed
16.Kan, L, Nagelberg, J, Maytal, J. Headaches in a pediatric emergency department: etiology, imaging, and treatment. Headache. 2000;40(1):25–9.CrossRefGoogle Scholar
17.Conicella, E, Raucci, U, Vanacore, N, et al. The child with headache in a pediatric emergency department. Headache. 2008;48(7):1005–11.CrossRefGoogle Scholar
18.Scagni, P, Pagliero, R. Headache in an Italian pediatric emergency department. J Headache Pain. 2008;9(2):83–7.CrossRefGoogle Scholar
19.Hsiao, HJ, Huang, JL, Hsia, SH, et al. Headache in the pediatric emergency service: a medical center experience. Pediatr Neonatol. 2014;55(3):208–12.CrossRefGoogle ScholarPubMed
20.Burton, LJ, Quinn, B, Pratt-Cheney, JL, Pourani, M. Headache etiology in a pediatric emergency department. Pediatr Emerg Care. 1997;13(1):1–4.CrossRefGoogle Scholar
21.Schobitz, E, Qureshi, F, Lewis, D. Pediatric headaches in the emergency department. Curr Pain Headache Rep. 2006;10(5):391–6.CrossRefGoogle ScholarPubMed
22.Leicht, MJ. Non-traumatic headache in the emergency department. Ann Emerg Med. 1980;9(8):404–9.CrossRefGoogle ScholarPubMed
23.Locker, T. Headache management: are we doing enough? An observational study of patients presenting with headache to the emergency department. Emerg Med J. 2004;21(3):327–32.CrossRefGoogle ScholarPubMed
24.Luda, E, Comitangelo, R, Sicuro, L. The symptom of headache in emergency departments: the experience of a neurology emergency department. Ital J Neurol Sci. 1995;16(4):295–301.CrossRefGoogle ScholarPubMed
25.McCarthy, LH, Cowan, RP. Comparison of parenteral treatments of acute primary headache in a large academic emergency department cohort. Cephalalgia. 2015;35(9):807–15.CrossRefGoogle Scholar
26.Lafata, JE, Moon, C, Leotta, C, et al. The medical care utilization and costs associated with migraine headache. J Gen Intern Med. 2004;19(10):1005–12.CrossRefGoogle Scholar
27.Friedman, BW, Serrano, D, Reed, M, Diamond, M, Lipton, RB. Use of the emergency department for severe headache: a population-based study. Headache. 2009;49(1):21–30.CrossRefGoogle ScholarPubMed
28.Bloudek, LM, Stokes, M, Buse, DC, et al. Cost of healthcare for patients with migraine in five European countries: results from the International Burden of Migraine Study (IBMS). J Headache Pain. 2012;13(5):361–78.CrossRefGoogle ScholarPubMed
29.Sanderson, JC, Devine, EB, Lipton, RB, et al. Headache-related health resource utilisation in chronic and episodic migraine across six countries. J Neurol Neurosurg Psychiatry. 2013;84(12):1309–17.CrossRefGoogle ScholarPubMed
30.Gerth, WC, Carides, GW, Dasbach, EJ, Visser, WH, Santanello, NC. The multinational impact of migraine symptoms on healthcare utilisation and work loss. Pharmacoeconomics. 2001;19(2):197–206.CrossRefGoogle ScholarPubMed
31.Wilper, A, Woolhandler, S, Himmelstein, D, Nardin, R. Impact of insurance status on migraine care in the United States: a population-based study. Neurology. 2010;74(15):1178–83.CrossRefGoogle ScholarPubMed
32.Buse, DC, Pearlman, SH, Reed, ML, et al. Opioid use and dependence among persons with migraine: results of the AMPP study. Headache. 2012;52(1):18–36.CrossRefGoogle ScholarPubMed
33.Minen, MT, Tanev, K. Influence of psychiatric comorbidities in migraineurs in the emergency department. Gen Hosp Psychiatry. 2014;36(5):533–8.CrossRefGoogle ScholarPubMed
34.Lipton, RB, Buse, DC, Serrano, D, Holland, S, Reed, ML. Examination of unmet treatment needs among persons with episodic migraine: results of the American Migraine Prevalence and Prevention (AMPP) Study. Headache. 2013;53(8):1300–11.CrossRefGoogle ScholarPubMed
35.Silberstein, SD, Winner, PK, Chmiel, JJ. Migraine preventive medication reduces resource utilization. Headache. 2003;43(3):171–8.CrossRefGoogle ScholarPubMed
36.Lainez, MJA. The effect of migraine prophylaxis on migraine-related resource use and productivity. CNS Drugs. 2009;23(9):727–38.CrossRefGoogle ScholarPubMed
37.Russell, M. Genetic epidemiology of migraine and cluster headache. Cephalalgia. 1997;17:683–701.CrossRefGoogle ScholarPubMed
38.Jensen, RM, Lyngberg, A, Jensen, RH. Burden of cluster headache. Cephalalgia. 2007;27(6):535–41.CrossRefGoogle ScholarPubMed
39.Gilbert, JW, Johnson, KM, Larkin, GL, Moore, CL. Atraumatic headache in US emergency departments: recent trends in CT/MRI utilisation and factors associated with severe intracranial pathology. Emerg Med J. 2012;29(7):576–81.CrossRefGoogle ScholarPubMed
40.Jordan, YJ, Lightfoote, JB, Jordan, JE. Computed tomography imaging in the management of headache in the emergency department: cost efficacy and policy implications. J Natl Med Assoc. 2009;101(4):331–5.Google ScholarPubMed
41.Larson, DB, Johnson, LW, Schnell, BM, et al. Rising use of CT in child visits to the emergency department in the United States, 1995–2008. Radiology. 2011;259(3):793–801.CrossRefGoogle Scholar
42.Gandhi, R, Lewis, E, Evans, J, Sell, E. Investigating the necessity of computed tomographic scans in children with headaches: a retrospective review. CJEM. 2014;16:33–8.Google Scholar
43.de Falco, FA, Sterzi, R, Toso, V, et al. The neurologist in the emergency department: an Italian nationwide epidemiological survey. Neurol Sci. 2008;29(2):67–75.CrossRefGoogle ScholarPubMed
44.Friedman, D, Feldon, S, Holloway, R, Fisher, S. Utilization, diagnosis, treatment and cost of migraine treatment in the emergency department. Headache. 2009;49(8):1163–73.CrossRefGoogle ScholarPubMed
45.Hawkins, K, Wang, S, Rupnow, M. Direct cost burden among insured US employees with migraine. Headache. 2008;48(4):553–63.CrossRefGoogle ScholarPubMed
46.Edmeads, J, Mackell, JA. The economic impact of migraine: an analysis of direct and indirect costs. Headache. 2002;42(6):501–9.CrossRefGoogle ScholarPubMed
47.Joish, VN, Cady, PS, Shaw, JW. Health care utilization by migraine patients: a 1998 Medicaid population study. Clin Ther. 2000;22(11):1346–56.CrossRefGoogle ScholarPubMed
48.Stokes, M, Becker, WJ, Lipton, RB, et al. Cost of health care among patients with chronic and episodic migraine in Canada and the USA: results from the International Burden of Migraine Study (IBMS). Headache. 2011;51(7):1058–77.CrossRefGoogle ScholarPubMed
49.Linde, M, Gustavsson, A, Stovner, LJ, et al. The cost of headache disorders in Europe: the Eurolight project. Eur J Neurol. 2012;19(5):703–11.CrossRefGoogle ScholarPubMed
50.Gaul, C, Finken, J, Biermann, J, et al. Treatment costs and indirect costs of cluster headache: a health economics analysis. Cephalalgia. 2011;31(16):1664–72.CrossRefGoogle ScholarPubMed
51.Colman, I, Rothney, A, Wright, S, Zilkalns, B, Rowe, BH. Use of narcotic analgesics in the emergency department treatment of migraine headache. Neurology. 2004;62(10):1695–700.CrossRefGoogle ScholarPubMed
52.Bailey, JE, Wan, JY, Mabry, LM, et al. Does health information exchange reduce unnecessary neuroimaging and improve quality of headache care in the emergency department? J Gen Intern Med. 2013;28(2):176–83.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×