Migraine is an extremely common condition affecting 28 million Americans. Fully 1 in every 6 adult women suffers from this malady. Patients with migraine are frequently seen in the Emergency Room and Urgent Care Clinic for acute treatment of their headaches. Headache generally accounts for nearly 3 % of all ER visits, resulting in almost 3.5 million visits annually. There currently are no widely used guidelines for the treatment of patients with headache in the ER or UCC, and reducing the number of CT scans remains a key goal for administrators in many ER or urgent care settings. In one study, 35 drugs, alone or in combination, were used to treat migraine. The most common medication class used was narcotics, which were used in 25% of the visits. The next two most commonly used classes were antiemetics and NSAIDs. Only 5% of patients seen for headache received headache-specific medications during their visit. ER and Urgent Care physicians generally have little or no formal training in treating these patients. Consequently, they often feel less comfortable ruling out secondary causes of headaches and using appropriate headache treatment medications and procedures. Since many patients have received narcotics in previous visits, providers may view them as drug seekers. Patients seen in ERs and UCCs for acute treatment of their headaches often report high levels of dissatisfaction. They often end up in the ER or UCC because they don’t have a formal treatment strategy for their severe headaches. Health plans and insurance agencies are often frustrated by the high cost of fragmented care for patients with headaches. Because of the environment that most ER and UCC providers operate in, many unnecessary scans and tests are done because of uncertainty of the diagnosis and unfamiliarity of the patient. Primary care physicians are also frustrated by patients with headaches presenting to them after being seen in the ER or UCC, wanting a refill of their narcotics that they were given. Many patients don’t follow up with their PCPs and simply keep returning to the ER/UCC for their treatment. In short, all involved in the care for patients with headache are frustrated by the current system. The care for these patients is clearly not optimal. It doesn’t have to be that way. There are a wide variety of effective treatment options available, but are underutilized in the acute setting. With these treatment options, patients no longer have to be treated only with parenteral narcotics, only to perpetuate the cycle of suboptimal care described above. This concise handbook covers all aspects of acute headache care, including care of the child and adolescent with acute headaches, treatment of pregnant and breastfeeding women with acute headaches and appropriate evaluation of secondary headaches. In addition, two other novel chapters are included: one on caring for older patients with acute headaches as well as a chapter describing how to ensure a seamless transition of the patient back to a headache interested provider. Representing an important milestone in the care of patients with headache, this is the first concise handbook available to exclusively address the issue of headache treatment in the acute care setting. Including protocols and strategies that can be used right away, Management of Headaches in Emergency Room and Urgent Care Settings: Diagnosis and Management provides information about lesser known, but effective strategies such as greater occipital nerve blocks that can be easily learned and incorporated in the acute care setting. It emphasizes the continuity of care that is so vital to keep headache patients from returning to the ER and UCC for acute treatment.

Do you need current and pragmatic guidance in meeting the challenges of acute headache assessment under pressure? Authored by renowned experts in neurology and emergency medicine, this versatile handbook offers practitioners a broad perspective on common, less-common, and rare headache disorders to enable accurate patient diagnosis and effective treatment. Featuring a multidisciplinary team of authors, this textbook provides clinicians who work in acute care settings with the right tools to recognise and understand primary headache disorders and life threatening causes of headache. Covering the best available evidence and practice standards from the emergency department, this guide provides direct answers to challenging management problems. Invaluable and extensively researched, practitioners are able to confidently evaluate a spectrum of conditions, while balancing resource utilization and cost considerations in a time-constrained environment.

Although headache is one of the most common complaints that patients bring to their clinicians, few physicians feel confident about its clinical evaluation and management. Is it a problem in its own right, or the presenting symptom of a serious medical condition? Loder, Rizzoli and Burch bring a practical case-based approach to this complex ailment, highlighting specific areas of diagnostic uncertainty in headache evaluation and treatment. Each case is taken from real-world clinical practice and reviews the diagnostic and treatment process in a systematic manner, identifying common challenges and pitfalls and describing newly issued treatment guidelines. Written in a question and answer format, this concise and useful guide in the Common Pitfalls series provides a step-by-step guide for everyday clinical practice, invaluable to anyone dealing with headache on a front-line basis.

This book describes the conceptualization, assessment, and evidence-based behavioral treatment of migraine and tension-type headache – two of the world's most common medical conditions, and also frequent, highly disabling comorbidities among psychiatric patients. Headache disorders at their core are neurobiological phenomena, but numerous behavioral factors play an integral role in their onset and maintenance – and many providers are unfamiliar with how to work effectively with these patients to ensure optimal outcomes. This book, the first major work on behavioral treatment of headache in over 20 years, provides much-needed help: An overview of relevant psychological factors and the behavioral conceptualization of headache is followed by a step-by-step, manual-type guide to implementing behavioral interventions within clinical practice settings. Mental health practitioners and trainees and other healthcare professionals who want to improve their headache patients' outcomes by supplementing routine medical treatment with empirically supported behavioral strategies will find this book invaluable.

This book synthesizes the current research on headache triggers and details how improving the measurement properties of trigger assessments can benefit clinical and research efforts. The book begins with a detailed exploration of the history of triggers and their use in attempts to assign causes to headache attacks. Subsequent chapters then expound on the existing schools of thought on headache triggers with discussions of understudied influences on the causal assignment process, such as the role of individual trigger beliefs and perceptions. After laying this groundwork, the practical application of trigger assessment is thoroughly detailed, including assessment design types and methods of analysis. Chapters then outline the applications of trigger assessment in research and clinical practice. To conclude, the book relays descriptions of future directions and evolving theories in the area. Concise and comprehensive, Assessing Headache Triggers is an invaluable resource for clinicians who treat patients and investigators who aim to improve the lives of individuals with headache through their research.

This important book describes the biopsychosocial nature of persisting and complex headache presentations following a mild brain trauma and offers a predominantly cognitive behavioural therapy programme to guide patients toward better health and less pain. The book provides both a robust theoretical underpinning and practical therapeutic guidance for helping those who suffer from posttraumatic headaches. Placing physical symptoms of trauma in context with personal and social issues, it discusses the broader psychological implications at work after brain injury, including the idea that headaches play a functional role for the patient. Updated with the latest research findings, the book features clinical guidelines, practitioner worksheets and relaxation scripts, offering an all-inclusive manual for therapists setting up their own programmes. Written with the busy clinician in mind, it is essential reading for anyone working with brain trauma survivors.

The Cleveland Clinic Manual of Headache Therapy is a hands-on, practical guide to diagnosis, work-up, and treatment of common headache disorders. Each chapter is written by a Cleveland Clinic Headache Center care provider. The book uses an evidence-based approach to sift through the wealth of available data and identify the most appropriate treatments. This manual is aimed at practicing neurologists and pain specialists, fellows and residents, and also primary care physicians. The Cleveland Clinic Manual is the most trusted source on this ever expanding and developing topic.