Take Home Points
- Hypertension rarely causes headache, it’s usually the other way around. Patients with headaches are in pain, and in turn, may have elevated blood pressures. Treat the underlying issue and you’ll treat the HTN at the same time.
- Get a pregnancy test on all female patients – you don’t want to miss a case of pre-eclampsia.
- Don’t rely on neuroimaging to r/o a subarachnoid hemorrhage. After 6 hours, the sensitivity of a non-contrast head ct drops off. If patients present after this time frame, and there is a high degree of suspicion, perform an LP and look for xanthochromia.
- Set expectations early! Tell patients they may not be 100% cured, we’re aiming for an improvement of their symptoms.
REBEL Core Cast – Basics of EM – Headache
Eric Steinberg, DO
Program Director – St. Joseph’s Emergency Medicine Residency
Director, Imaging Curriculum – Foundations of Emergency Medicine
Editorial Board – MDCalc
ALL NYC EM Faculty
Post Peer Reviewed By: Anand Swaminathan, MD (Twitter: @EMSwami)