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Acute Headaches; Presenting Symptoms And Diagnostic Rules To Identify Patients With Tension And Migraine Headache , Paula Diehr

Paula Diehr

Headache is the ninth most common cause of physician visits, but data on acute headaches have not been collected in a standardized manner and have not been analyzed in a multivariate fashion. We report on 726 patients presenting with acute headaches, which were diagnosed as tension (38%), migraine (25%), no diagnosis (30%), and other (6%). The prevalence of 32 signs and symptoms is shown for each group. Four of these findings were significant predictors of tension headache, and 19 were significant predictors of migraine headache (p<.05). Several diagnostic rules are developed which classify nearly 90% of the headaches correctly, using only three to seven of the findings. On a new set of patients the classification was correct over 80% of the time. It is suggested that most acute headaches could be diagnosed over the telephone or by midlevel providers, which would provide substantial cost savings.