Acute headache

Headache is very common and affects almost everyone at some point. Most patients have primary headache and present non-acutely to their General Practitioner (GP). A small proportion will, however, present acutely, either directly to the emergency department (ED) or to acute medical units via their GP. A significant proportion of these patients will have a sinister cause for their headache. It is the job of the attending doctor to successfully identify those patients who require investigation to rule out a sinister cause and reassure and manage the majority who have a benign headache syndrome. This article focuses on the diagnosis and management of acute and recent-onset headache in the ED and acute medical unit.