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 or to acute medical units (AMU) via their GP. A significant proportion of these patients will have a serious cause for their headache. It is the job of the attending doctor successfully to identify those patients who require investigation to rule out a sinister cause, and to 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 presenting acutely.