Kastamonu Medical Journal regularly publishes internationally qualified issues in the field of Medicine in the light of up-to-date information.

EndNote Style
Original Article
Evaluation of patients presenting with headache to the emergency outpatient clinic
Aims: This study aimed to explore the factors contributing to headache presentation in patients by recognizing headache as a symptom of various potential ailments. It is crucial to understand these factors for appropriate assessment and treatment planning in patients with headaches. Additionally, this study investigated patients' preferences for headache management, which is an understudied aspect in the field.
Methods: In 2012, a two-month study was conducted at an emergency department outpatient clinic to assess the general characteristics, severity, frequency, duration, and location of headache episodes among patients presenting with headache complaints. The study analyzed various parameters, including the different types of pain, such as throbbing, stabbing, and burning, as well as the impact of headaches on daily performance, medication use, specific medications taken, and alternative treatment methods via a headache questionnaire.
Results: The survey results revealed that 21.7% of the patients described their pain as extremely severe, 52.2% as severe, and 26.1% as distressing. Pain descriptions were predominantly throbbing (79.4%) and pain (62.2%), with sensations of pressure (20%), stabbing (18.3%), pulsating (13.3%), burning (10.6%), and constriction-like a band (2.8%). The localization of pain was bilateral in 15.0% of patients, unilateral in 18.3%, around or behind the eyes in 28.3%, and in the neck or back of the head in 38.3%. Headaches were found to affect the work life of 40.6% of patients, 20% reported no impact, and 39.4% experienced occasional interference. No significant statistical difference was observed regarding the intensity, frequency, and duration of pain, and its impact on work life with respect to sex. The usage of non-prescription medication was high (92.8 %), whereas prescription medication usage was 57.8%. Regarding alternative treatment methods, massage therapy was used by 53.6% of the patients and herbal treatments by 17.8%.
Conclusion: This study examined the frequency and handling of headaches among patients visiting an emergency department. The results indicate that headaches affect both sexes equally, with a marginal prevalence in females. To provide better care, addressing patients’ preferences and experiences is important. As patients rely on non-prescription medications and alternative therapies, concerns regarding healthcare accessibility arise. A combination of medication management, patient education, and non-pharmacological therapies is necessary to achieve better outcomes and decrease the burden on healthcare systems.

1. Robbins MS. Diagnosis and management of headache: a review. JAMA.2021;325(18):1874-1885.
2. Saylor D, Steiner TJ. The global burden of headache. Semin Neurol. 2018;38(2):182-190.
3. Caponnetto V, Deodato M, Robotti M, et al. Comorbidities of primaryheadache disorders: a literature review with meta-analysis. J HeadachePain. 2021;22(1):71.
4. Giamberardino MA, Affaitati G, Costantini R, Guglielmetti M, MartellettiP. Acute headache management in emergency department. A narrativereview. Intern Emerg Med. 2020;15(1):109-117.
5. Kubik SU, Martin PR. The headache triggers sensitivity and avoidancequestionnaire: establishing the psychometric properties of thequestionnaire. Headache. 2017;57(2):236-254.
6. Chung PW, Cho SJ, Kim BK, et al. Development and validation of thecluster headache screening questionnaire. J Clin Neurol. 2019;15(1):90-96.
7. Steiner TJ, Gururaj G, Andrée C, et al. Diagnosis, prevalence estimationand burden measurement in population surveys of headache: presentingthe HARDSHIP questionnaire. J Headache Pain. 2014;15(1):3.
8. Burish MJ, Pearson SM, Shapiro RE, Zhang W, Schor LI. Cluster headacheis one of the most intensely painful human conditions: results from theInternational Cluster Headache Questionnaire. Headache. 2021;61(1):117-124.
9. Walling A. Frequent headaches: evaluation and management. Am FamPhysician. 2020;101(7):419-428.
10. Ailani J, Burch RC, Robbins MS; Board of Directors of the AmericanHeadache Society. The American Headache Society Consensus Statement:update on integrating new migraine treatments into clinical practice.Headache. 2021;61(7):1021-1039.
11. Bottiroli S, Renzi A, Ballante E, et al. Personality in chronic headache: asystematic review with meta-analysis. Pain Res Manag. 2023;2023:6685372.
12. Sun-Edelstein C, Rapoport AM, Rattanawong W, Srikiatkhachorn A. Theevolution of medication overuse headache: history, pathophysiology andclinical update. CNS Drugs. 2021;35(5):545-565.
13. Westergaard ML, Lau CJ, Allesøe K, Gjendal ST, Jensen RH. Monitoringchronic headache and medication-overuse headache prevalence inDenmark. Cephalalgia. 2020;40(1):6-18.
14. Kaur K, Hernandez V, Al Hajaj SW, et al. The efficacy of herbal supplementsand nutraceuticals for prevention of migraine: can they help? Cureus.2021;13(5):e14868.
15. Katsuki M, Kawamura S, Kashiwagi K, Koh A. Medication overuseheadache successfully treated by Japanese herbal kampo medicine,yokukansan. Cureus. 2021;13(9):e18326.
16. Rossi MF, Tumminello A, Marconi M, et al. Sex and gender differences inmigraines: a narrative review. Neurol Sci. 2022;43(9):5729-5734.
17. Fuensalida-Novo S, Parás-Bravo P, Jiménez-Antona C, et al. Genderdifferences in clinical and psychological variables associated with theburden of headache in tension-type headache. Women Health. 2020;60(6):652-663.
18. Al-Hassany L, Haas J, Piccininni M, Kurth T, Maassen Van Den Brink A,Rohmann JL. Giving researchers a headache-sex and gender differencesin migraine. Front Neurol. 2020;11:549038.
19. Katsuki M, Kashiwagi K, Kawamura S, Koh A. The efficacy of Japaneseherbal kampo medicine as an acute and prophylactic medication to treatchronic daily headache and medication overuse headache:-Single armretrospective study. Cureus. 2022;14(5):e25419.
20. Lopresti AL, Smith SJ, Drummond PD. Herbal treatments for migraine: asystematic review of randomised-controlled studies. Phytother Res. 2020;34(10):2493-2517.
Volume 4, Issue 2, 2024
Page : 62-67