Emergency headache: a ‘proper’ desktop reference

Headache is a common problem. We've all had them—especially at 3 am after the fifth call and no meal break—and the figures back this up. In primary care, 4% of consultations relate to headache, being the most common neurological presenting condition in accident and emergency (A&E), with figures for attendance due to headache rising steadily year on year (Thames Valley Strategic Clinical Networks, 2017).

So it stands to reason that as ambulance clinicians, we will come across it regularly as a presenting condition. In one trust last month, there were 15 calls a day, every day, to 999 for ‘headache’. Not only is it common, it is also complex. First there are primary or secondary headaches, and these two groups then split further into other groups, some of which split even further. Add to this the fact that one of the most commonly presenting primary headaches is also a ‘stroke mimic’, and it all gets rather difficult.