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Trigeminal autonomic cephalalgias (TACs) are primary headaches responsible for unilateral facial and/or cranial pain with ipsilateral autonomic signs. In the absence of any radiological or biological marker, diagnosis relies upon clinical history. Patients are often misdiagnosed as having secondary headaches due to sinus, dental, or eye disorders or as having migraine, leading to inadequate management. Efficient treatments do exist, and differ among the various TACs. Patients with TACs often present to the emergency department (ED) with excruciating headache. These are pain urgencies that require quick diagnosis and tailored treatment. Therefore, management of TACs, and especially of cluster headache (CH), the most common TAC, should be well known by ED physicians.
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