Review Article

Neurological Sciences

, Volume 31, Issue 5, pp 545-553

Management of primary headaches in adult Emergency Departments: a literature review, the Parma ED experience and a therapy flow chart proposal

  • Paola TorelliAffiliated withHeadache Center, Department of Neuroscience, University of Parma Email author 
  • , Valentina CampanaAffiliated withEmergency Department, Parma University Hospital
  • , Gianfranco CervellinAffiliated withEmergency Department, Parma University Hospital
  • , Gian Camillo ManzoniAffiliated withHeadache Center, Department of Neuroscience, University of Parma

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Abstract

Adults seeking treatment at hospitals’ Emergency Departments (EDs) because of headache represent a major health-care issue. To date, there are no special guidelines for management of primary headache in adults seen at EDs and therapeutic approaches are often inconsistent. This review describes the therapeutic strategies that are most frequently used to treat primary headache in adult ED patients and their in situ efficacy, based on literature data, the type of medications studied in randomized clinical trials for the management of adult ED patients, and the recommendations found in the guidelines for symptomatic treatment of migraine. We also report on the experience of the Parma University Hospital ED in the year 2007 for the management of adult patients diagnosed with primary headache. Finally, we propose an algorithm for primary headache management in ED patients, which is based on the literature data and clinical experience, and is suitable for application in Italy.

Keywords

Acute headache Migraine Tension-type headache Emergency Department Therapy Triptans