In this episode from the ACEP-EQUAL series, Drs. Godwin and Shih review the recently published ACEP clinical policy regarding the treatment of headaches in the emergency department.
Dr. Steven Godwin, Professor and Chair, Department of Emergency Medicine University of Florida
Dr. Richard Shih, Professor of Integrated Medical Science and Program , Charles E Schmidt College of Medicine at Florida Atlantic University
Host: Jason Woods, MDwww.acep.org/equal
Perry JJ et al. Clinical decision rules to rule out subarachnoid hemorrhage for acute headache. JAMA. 2013 Sep 25;310(12):1248-55. doi: 10.1001/jama.2013.278018
Carpenter CR et al. Spontaneous Subarachnoid Hemorrhage. A Systematic Review and Meta-analysis Describing the Diagnostic Accuracy of History, Physical Exam, Imaging, and Lumbar Puncture With an Exploration of Test Thresholds. Acad Emerg Med. 2016 Sep;23(9):963-1003. doi: 10.1111/acem.12984. Epub 2016 Sep 6.
Perry JJ. Sensitivity of computed tomography performed within six hours of onset of headache for diagnosis of subarachnoid haemorrhage: prospective cohort study. BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d4277
Dubosh NM et al. Sensitivity of Early Brain Computed Tomography to Exclude Aneurysmal Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis.Stroke. 2016 Mar;47(3):750-5. doi: 10.1161/STROKEAHA.115.011386.
Carstairs SD. Computed tomographic angiography for the evaluation of aneruysmal subarachnoid hemorrhage. Acad Emerg Med. 2006 May;13(5):486-92. Epub 2006 Mar 21.
El Khaldi M. et al. Detection of cerebral aneurysms in nontraumatic subarachnoid haemorrhage: role of multislice CT angiography in 130 consecutive patients. La radiologia medica. 200 Feb;112(1):123–137.
Menke J et al. Diagnosing cerebral aneurysms by computed tomographic angiography: meta-analysis. Ann Neurol. 2011 Apr;69(4):646-54. doi: 10.1002/ana.22270.
Friedman BW et al. Randomized study of IV prochlorperazine plus diphenhydramine vs IV hydromorphone for migraine. Neurology. 2017 Nov 14; 89(20): 2075–2082. doi: 10.1212/WNL.0000000000004642