Emergency Department and Inpatient Management of Headache in Adults
This article reviews treatment options for patients presenting with headache in the emergency department (ED) and for inpatients, including red flags and status migrainosus (SM).Recent FindingsMost patients presenting with headache in the ED will have migraine, but red flags must be reviewed to rule out secondary headaches. SM refractory to home treatment is a common reason for ED presentation or inpatient admission, but high-quality treatment evidence is lacking. Common treatments include intravenous fluids, anti-dopaminergic agents with diphenhydramine, steroids, divalproex, nonsteroidal anti-inflammatory drugs, intravenous dihydroergotamine, and nerve blocks. Other therapies (e.g., ketamine and lidocaine) are used with limited or inconsistent evidence. There is evidence for inpatient behavioral management therapy.SummaryThis article details red flags to review in the workup of headache presentation in the ED and provides a step-wise approach to ED and inpatient management. However, more studies are needed to better optimize care.
Conditions: Tinnitus, Subjective; Tinnitus Interventions: Drug: Nortriptyline + topiramate; Drug: Verapamil + paroxetine; Other: Placebo Sponsor: University of California, Irvine Recruiting
Conclusions: Identifying WNV infection early in its clinical course would help in decreasing inappropriate antibiotic use when patients presented with fever and meningeal symptoms. Performing WNV serology in CSF studies is critical in making the diagnosis. PMID: 32454831 [PubMed - as supplied by publisher]
ConclusionsWe found no difference in RCPmi volume between migraine patients and controls, suggesting no structural RCPmi pathology in migraine.
MIGRAINES are debilitating, and 12 percent of the nation suffers from them. Here's how to prevent migraines.
Acase report inSchizophrenia Bulletin suggests that patients who are taking clozapine may be at risk of clozapine toxicity if they become infected with COVID-19. Clozapine is considered the best option for patients with treatment-resistant schizophrenia, but patients taking the medication are at heightened risk of a rare but serious condition known as neutropenia, which can increase risk of severe infections.In theSchizophrenia Bulletinreport, Thomas Cranshaw, M.B.B.S., and Thiyyancheri Harikumar, M.B.B.S., of Cumbria, Northumberland, Tyne, and Wear NHS Foundation Trust in England, described a 38-year-old man in an inpatie...
Condition: Post-Dural Puncture Headache Intervention: Drug: Sphenopalatine Ganglion Block using 4% lidocaine Sponsor: Zagazig University Recruiting
Conditions: Cervicogenic Headache; Headache Interventions: Other: Manual Therapy and Exercises; Other: Exercise Sponsor: Universidad de Zaragoza Recruiting
Condition: Migraine Intervention: Drug: Topiramate Sponsor: SK Chemicals Co., Ltd. Not yet recruiting
Publication date: Available online 25 May 2020Source: MitochondrionAuthor(s): Laurie H Tiehuis, Saskia Koene, Christiaan GJ Saris, Mirian CH Janssen
IMPORTANCE: The prognosis of post-traumatic headache is poorly understood. OBJECTIVE: To develop and validate a prognostic model to predict the presence of post-traumatic headache six months after a traffic collision in adults with incident post-traumati...