Book contents
- Emergency Headache
- Emergency Headache
- Copyright page
- Contents
- Contributors
- Preface
- 1 Introduction
- 2 Epidemiology of Headache in the Emergency Department
- 3 Approach to History Taking and the Physical Examination
- 4 Approach to Investigations
- 5 Thunderclap Headache in the Emergency Department
- 6 Other Secondary Headaches in the Emergency Department
- 7 The Migraine Patient in the Emergency Department
- 8 The Patient with a Trigeminal Autonomic Cephalalgia in the Emergency Department
- 9 Other Primary Headache Disorders That Can Present to the Emergency Department
- 10 Medication Overuse Headache in the Emergency Department
- 11 Approach to the Pediatric Patient with Headache in the Emergency Department
- 12 Approach to Pregnant or Lactating Patients with Headache in the Emergency Department
- 13 Approach to the Elderly Patient with Headache in the Emergency Department
- 14 Preventing Emergency Department Visits in Primary Headache Patients and Prevention of Bounce-Backs to the Emergency Department
- Index
- References
5 - Thunderclap Headache in the Emergency Department
Published online by Cambridge University Press: 09 October 2017
Book contents
- Emergency Headache
- Emergency Headache
- Copyright page
- Contents
- Contributors
- Preface
- 1 Introduction
- 2 Epidemiology of Headache in the Emergency Department
- 3 Approach to History Taking and the Physical Examination
- 4 Approach to Investigations
- 5 Thunderclap Headache in the Emergency Department
- 6 Other Secondary Headaches in the Emergency Department
- 7 The Migraine Patient in the Emergency Department
- 8 The Patient with a Trigeminal Autonomic Cephalalgia in the Emergency Department
- 9 Other Primary Headache Disorders That Can Present to the Emergency Department
- 10 Medication Overuse Headache in the Emergency Department
- 11 Approach to the Pediatric Patient with Headache in the Emergency Department
- 12 Approach to Pregnant or Lactating Patients with Headache in the Emergency Department
- 13 Approach to the Elderly Patient with Headache in the Emergency Department
- 14 Preventing Emergency Department Visits in Primary Headache Patients and Prevention of Bounce-Backs to the Emergency Department
- Index
- References
Summary
Put simply, the sun should not set on an undiagnosed thunderclap headache.
JF RothrockAbstract
A person presenting with a thunderclap headache is at high risk of a life-threatening condition – 4–5 times greater risk than those who are in the “rule-out MI” or “rule-out pulmonary embolism” category. Of those who do have a high-risk condition, 30–50 percent will not have a subarachnoid hemorrhage (SAH). Many emergency physicians discharge people with thunderclap headaches after a computed tomography (CT) and a lumbar puncture (LP) have ruled out an SAH, but this strategy needs to change and encompass consultation and additional imaging if that first series of investigations is negative. There are many other conditions that can present with a thunderclap headache. This chapter will review the differential diagnosis, and the signs and symptoms of each; it will conclude with recommendations on a comprehensive approach in the emergency department (ED) for someone presenting with a thunderclap headache.
- Type
- Chapter
- Information
- Emergency HeadacheDiagnosis and Management, pp. 43 - 49Publisher: Cambridge University PressPrint publication year: 2017
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