Epidemiology of headache in a neurological Emergency Department in Medellin, Colombia

Abstract

IntroductionHeadache is a common reason for presentation to emergency departments (ED) around the world. In many countries, ED are not speciality-focussed, however, in Colombia and some other countries, specialist neurological hospitals have ED with a strong neurological focus. For patients presenting with headache, these ED may have different epidemiology, investigation strategies and treatment patterns from general ED. The objective of this study was to describe the epidemiology of headache presenting to the ED of Instituto Neurológico de Colombia in Medellin, Colombia – an ED which is a referral centre for neurological and neurosurgical diseases. MethodsThis was an observational study by chart review of adults (aged ≥18) with a main presenting compliant of headache. Demographic, clinical, imaging, diagnoses and outcome data were collected.  The primary outcome of interest was the rate of serious secondary intracranial headache cause. Analysis was descriptive.ConclusionDiagnosis of headache in ED is challenging with a very wide range of possible causes. A small proportion of patients (approx. 9%) have a serious cause for their symptoms – a proportion similar to that reported in other international emergency department cohorts.