Headache accounts for a significant number of cases presenting to the Emergency Department (ED) and has a high societal cost, contributed by recurrent ED and clinic visits, and unnecessary diagnostic tests.
This review article covers the important clinical tools needed to evaluate headaches in both adults and children in the ED.
Medline/PubMed was searched using the keywords “Emergency department”, “headache”, “adult”, “pediatric”, “clinical assessment”, “diagnosis” and “treatment”, in the title or abstract. The search covers the period from 1 January 1990 to 31 December 2019.
The articles selected were based on their relevancy to the objective of this review article. Additional relevant publications were identified from article references lists.
The emergency physician plays a key role in differentiating between primary and secondary headaches. Within the limited ED resources, appropriate diagnostic testing should be used to identify the life-threatening headaches. This will ensure patients are given the appropriate evidence-based pharmacological therapy and holistic management.

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