Evaluation of patients admitted to the emergency department with headache and undergoing neuroimaging

Aim: It is of great importance to differentiate the primary or secondary causes of headaches in the intensity of emergency services. The underlying causes of secondary headaches can be caused by neurological causes and may have a mortal course. In this study, it was aimed to determine red flags in neuroimaging for life-threatening secondary causes of patients who applied to the emergency department with headache complaints and underwent brain imaging. Material and Methods: Our study was planned retrospectively and descriptively. Patients who presented to the 3rd step emergency department with headache within 10 years were included. Demographic characteristics, disease history and information, imaging information and results of the patients were recorded. Results: In this study, the mean age of 704 patients was 48.9 (17-92) years, 62.8% of whom were female, and 99.6% of the patients presented to the department within the first 24 hours after headache. Their cranial CT scans identified intracranial pathologies in 19.2% (n=139) of the patients. Intracranial pathologies were detected in 27.5% who experienced the most severe headache in their life, in 31.7% who had a sudden headache, in 52.9% who had focal neurological deficits, in 23.8% who were older than 50 years old, and in other headache reasons. Discussion: In the study on the elimination of secondary headaches in the emergency room, we concluded that having the most severe headache ever, sudden onset, neurological deficit, and being over 50 years of age are warning criteria. Although brain CT scans are generally used in clinically suspicious situations, MRI should also be used for mortality and morbidity in these patients.