From the Guidelines
Headache is primarily classified under the neurology unit. This is because headaches are neurological symptoms that involve pain in the head region, which is regulated by the nervous system. Neurologists are the specialists who typically manage and treat various types of headaches, including migraines, tension headaches, cluster headaches, and secondary headaches caused by underlying conditions. The evaluation of headaches often involves neurological examination and sometimes neuroimaging studies like CT scans or MRIs to rule out serious causes. Treatment approaches may include medications such as analgesics, triptans, preventive medications like beta-blockers or anticonvulsants, and non-pharmacological interventions. While some headaches may have causes related to other systems (like sinus headaches which might involve ENT, or headaches due to eye strain which might involve ophthalmology), the primary specialty responsible for diagnosing and managing headache disorders is neurology, as supported by recent guidelines and studies 1.
Some key points to consider in the management of headaches include:
- The use of aspirin-acetaminophen-caffeine for acute migraine treatment 1
- The consideration of CGRP monoclonal antibodies, such as erenumab, fremanezumab, and galcanezumab, for the prevention of episodic and chronic migraine 1
- The role of neurotoxin injections, such as onabotulinumtoxinA, in the prevention of chronic migraine 1
- The importance of non-pharmacological interventions, such as physical therapy and aerobic exercise, in the management of migraine and tension-type headache 1
Overall, the management of headaches requires a comprehensive approach that takes into account the individual patient's needs and preferences, as well as the latest evidence-based guidelines and treatments. Neurologists play a critical role in this process, working closely with other healthcare professionals to provide optimal care for patients with headache disorders.
From the Research
Headache Unit Classification
- Headache is typically classified under the neurology unit, as it involves the diagnosis and management of neurological disorders related to the brain and nervous system 2, 3.
- The evaluation and management of headaches in the emergency department (ED) often require a multidisciplinary approach, involving neurologists, emergency medicine physicians, and other healthcare professionals 4, 5.
Neurological Aspects of Headache
- Headaches can be primary or secondary, with primary headaches being unrelated to an underlying medical condition and secondary headaches being caused by an underlying medical condition 4.
- Neurological examination and diagnostic tests, such as neuroimaging and lumbar puncture, may be necessary to rule out secondary causes of headache and to diagnose primary headache disorders 2, 3.
Management of Headache
- The management of headache in the ED typically involves pharmacological treatment, with medications such as NSAIDs, triptans, and corticosteroids being commonly used 2, 6.
- Referral to a headache center or a neurologist may be necessary for further evaluation and management of headache disorders, particularly for patients with complex or refractory headaches 2, 5.