Sudden headache in the emergency department

Abstract

An accurate history will identify who has had a true acute onset headache (maximal within seconds to minutes), but it will not allow you to identify accurately the benign primary syndromes within this group, even though they are the majority. Thus all patients with a true acute onset headache require investigation to exclude SAH. If the history is not suggestive of SAH (i.e. it is not an acute onset headache), then investigation for SAH is inappropriate (of course other suggested diagnoses may require investigation). So the history is of vital importance in the decision making process. © 2005 Blackwell Publishing Ltd.