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. 2025 Oct;37(5):e70138.
doi: 10.1111/1742-6723.70138.

What Proportion of Emergency Department Headache Patients With Normal Neurology Have a Serious Secondary Headache Cause? A HEAD Study Report

Anne Maree Kelly  1   2 , Kevin H Chu  3   4 , Win Sen Kuan  5   6 , Gerben Keijzers  7   8   9 , Frances B Kinnear  10   11 , Alejandro Cardozo-Ocampo  12 ; HEAD Study and HEAD Colombia Investigators
Collaborators, Affiliations

What Proportion of Emergency Department Headache Patients With Normal Neurology Have a Serious Secondary Headache Cause? A HEAD Study Report

Anne Maree Kelly et al. Emerg Med Australas. 2025 Oct.

Abstract

Objectives: To estimate the proportion of Emergency Department (ED) headache patients without neurological features who are diagnosed with a serious secondary headache cause.

Methods: Unplanned secondary analysis of HEAD Study/HEAD Colombia data. Patients without a known history of cerebral conditions and with a normal neurological assessment were included. The outcome of interest was the proportion of patients diagnosed with a serious secondary headache cause.

Results: One hundred ninety-one patients were diagnosed with a serious secondary headache cause (191/3951, 4.8%, 95% CI 4.2%-5.5%).

Conclusion: Absence of neurological features alone cannot be used to reliably exclude a serious secondary headache cause in ED patients.

Keywords: emergency department; headache; outcome.

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Conflict of interest statement

A.M.K. and G.K. are section editors for EMA. To minimize bias, they were excluded from all editorial decision‐making related to the acceptance of this article for publication. The other authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Sample derivation.
See this image and copyright information in PMC

References

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