Evaluation and Emergency Treatment of Headache

Silberstein, F.A.C.P. Stephen D.

doi:10.1111/j.1526-4610.1992.hed3208396.x

Cited by 68 publications

(31 citation statements)

References 29 publications

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“…Nossos resultados confirmam dados conhecidos. A cefaléia rebelde aos tratamentos caseiros e aos instituídos num primeiro atendimento, em geral melhora com medidas simples, nos grandes hospitais e em unidades especializadas em atendimento de cefaléia 12,13 . Tal observação demonstra o papel importante da segurança, atenção e tranqüilização na melhora da crise.…”

Section: Discussionunclassified

Tratamento da cefaléia em uma unidade de emergência da cidade de Ribeirão Preto

Bigal¹,

Bordini²,

Speciali

1999

Arq. Neuro-Psiquiatr.

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RESUMO -Cefaléia é dos sintomas mais comuns na prática clínica. Acarreta considerável impacto econômico e sobrecarrega as unidades de emergência. A maioria destas, em nosso país, não dispõe de triptans. O presente estudo analisa o tratamento instituído na Unidade de Emergência do Hospital das Clínicas de Ribeirão Preto. Em 1996, 1254 pacientes foram atendidos com esta queixa e 64 necessitaram de internação. Dos pacientes não internados (NI), 77% apresentavam cefaléias primárias, contra 29,7% dos pacientes internados (I). A percentagem de melhora nos pacientes com migrânea com a dipirona endovenosa foi 83,8%, com o diclofenaco intramuscular 66,7% e com a clorpromazina (endovenosa) 81,8%. As percentagens de pacientes com cefaléia do tipo tensional que melhoraram, frente às mesmas drogas foram, respectivamente 77,8%, 80% e 100%. Dos NI 16,3% tiveram melhora sem qualquer tratamento medicamentoso. Concluímos que as drogas utilizadas apresentam perfis semelhantes de eficácia e custo, podendo ser utilizadas em unidades básicas de saúde. O maior inconveniente é a administração parenteral.PALAVRAS-CHAVE: cefaléia, unidade de emergência, tratamento. Headache treatment in an emergency room of the city of Ribeirão Preto, BrazilABSTRACT -Headache is one of the most common symptoms observed in clinical practice. It has a considerable economic impact and overburdens emergency rooms. In Brazil, most emergency rooms have no tryptans. The present study analyses the treatment provided by the Emergency Room of the University Hospital of Ribeirão Preto. In 1996, 1254 patients were treated for headache and 64 of them required hospitalization. Of the nonhospitalized (NH) patients, 77% had primary headache, as opposed to 29.7% of hospitalized patients. Of the patients with migraine, 83.6% improved with intravenous dipyrone, 66.7% improved with intramuscular diclofenac and 81.8% improved with intravenous chlorpromazine. The percentages of patients with tension-type headache who improved with the same drugs were 77.8%, 80% and 100%, respectively. Among NH patients, 16.3% improved without any medication. We conclude that the drugs used have similar efficacy profiles and costs and can be used at basic health unities. The major drawback is parenteral administration.KEY WORDS: headache, emergency room, treatment.Desde os primórdios da civilização o ser humano preocupa-se com o sintoma cefaléia, em especial com seu tratamento, pois é queixa freqüente na população e nos atendimentos médicos. A prevalência anual na população é de 70% a 90% [1][2][3][4][5] . As conseqüências vêm sendo calculadas e comprovadamente acarreta prejuízos econômicos consideráveis, além de diminuição importante na qualidade de vida de seus portadores [6][7][8][9] . Considerando sua elevada prevalência, poucos estudos foram conduzidos no Brasil, em particular no que diz respeito ao seu tratamento em emergências 10 . Em nosso meio, boa parte dos hospitais públicos não conta com medicações específicas para o tratamento

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Section: Discussionunclassified

Tratamento da cefaléia em uma unidade de emergência da cidade de Ribeirão Preto

Bigal¹,

Bordini²,

Speciali

1999

Arq. Neuro-Psiquiatr.

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“…A retrospective study of presenting signs and symptoms of brain tumors to the emergency department identified headache as the initial symptom in 56% of patients [51]. Headache was found to be the initial and single symptom in brain tumors in only 8% of patients, far below the incidence reported in previous retrospective studies [12•].…”

Section: Brain Tumor Headache: Evaluation In An Emergency Care Settingmentioning

confidence: 97%

Headache related to brain tumors

Loghin¹,

Levin

2006

Curr Treat Options Neurol

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Headache is one of the most common somatic complaints of patients seeking medical care. Most headaches are not of serious cause and can be diagnosed easily with a good history and physical examination. The challenges to the physician are to determine when underlying intracranial pathology may be causing the symptoms and signs, and to identify the few patients in whom a tumor is the cause of the headache. The subject of headache in patients with brain tumors has been reviewed in neurologic textbooks and in several investigations before, as well as after, modern imaging diagnostic techniques became available. Headache can also manifest as an acute or chronic complication of radiation treatment and/or chemotherapy in patients with intracranial neoplasm, but there are few data in the literature specifically addressing this subject. This article provides an overview of headache in patients with primary and secondary brain tumor, including headache characteristics, the putative mechanism for these headaches, the role of diagnostic testing, and the general principles of management.

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“…Headache is a common complaint in patients presenting to the Emergency Department (ED) (1)(2)(3). Many patients seek care for headache in EDs because of the severity of the pain and associated symptoms, concerns about the etiology, lack of alternative venues of healthcare, and "last straw" desperation.…”

Section: Introductionmentioning

confidence: 99%