The management of acute headache in adults in an acute admissions unit

There have been no previously published studies about acute admissions with headaches to a medical admissions ward. In our retrospective case-note stu dy of all patients admitted with headaches to the acute medical admission w ard of Ninewells Hospital, Dundee over a six-month period, there were 114 a dmissions with headache (2.4% of all admissions). CT scans were done in 68 (59.6%) and were abnormal in 21 patients. Twenty four patients (21.1%) had serious underlying causes for headaches. Predictors for CT abnormalities ar e discussed. Eighteen patients had lumbar punctures and six had abnormal re sults. Most patients were discharged after one day, nine were transferred t o the neurosurgical unit and there were two deaths. Deficiencies in record keeping were identified as was a lack of precision in diagnosis. Changes in practice are needed to improve patient care and perhaps national guideline s are required.