ACEP Clinical Policy — Headache in the Emergency Department (2019)

The ACEP 2019 Clinical Policy on evaluation and management of adult patients with acute headache in the emergency department provides evidence-based recommendations for: identifying dangerous secondary causes of headache (subarachnoid hemorrhage, meningitis, venous thrombosis, hypertensive emergency), appropriate neuroimaging utilization, and parenteral treatment protocols for acute migraine and headache syndromes. Headache accounts for approximately 3–5% of all ED visits annually (~2–3 million visits). Less than 5% of all ED headache presentations represent life-threatening etiologies, yet distinguishing dangerous from benign headache remains the critical ED clinical challenge.