J Korean Soc Emerg Med.  1999 Mar;10(1):78-84.

Indication of Evaluation and Hospitalization in Patients of Alert Mental state who Visit Emergency Department due to Headache

• Ryoo JH
• Heo T
• Min YI

Abstract

BACKGROUND: Headache is a common symptom. It has not proved useful methods that the physician evaluated the alert patient who had headache. It needs the presence of predictors of intracranial pathology(ICP) which serves as influential factors in the indication of evaluation and hospitalization of patients. METHOD: So, in order to identify such factors, patient records were retrospectively analysed. 168 patients with the chief complaint of headache presented to the Emergency Department of Chonnam University Hospital during the period from January 1, 1995 to December 31, 1997. All were in an alert mental state and had no evidence of trauma and intoxication.
RESULTS
14 cases(8.3% revealed ICP. 41 cases(24.4% revealed systemic disease. The remainder of cases were divided among unclassified headaches(61 cases, 36.3%, tension headaches(30 cases, 17.9%, and migraine(22 cases, 13.1%. Comparison of ICP-positive and ICP-positive cases revealed that ICP-Positive Patients could be categorized by the following findings: (1) Presence of the focal sign through neurological examination, (2) age greater than 55 years, (3) presence of associated symptoms, (4) acute headache. These four manifestations were proven to be statistically significant as predictors of ICP.
CONCLUSION
Although the positive predictive value of the above criteria is not perfect for the prediction of ICP, they are worthy of clinical consideration in alert patients presenting with headache.

MeSH Terms

Emergencies*
Emergency Service, Hospital*
Headache*
Hospitalization*
Humans
Jeollanam-do
Neurologic Examination
Retrospective Studies