Estruturação do Raciocínio Clínico para Cefaleias em Urgências e Emergências
Estruturação do Raciocínio Clínico para Cefaleias em Urgências e Emergências
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DOI: https://doi.org/10.22533/at.ed.1561325160411
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Palavras-chave: Cefaleia primária; Cefaleia secundária; Diagnóstico diferencial; Fluxograma clínico; Prevenção de cefaleias; Triagem neurológica; Abordagem em pronto atendimento.
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Keywords: Primary headache; Secondary headache; Differential diagnosis; Clinical flowchart; Headache prevention; Neurological screening; Emergency department management.
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Abstract: Headache ranks among the five leading causes of emergency department visits. Despite being extensively discussed in the literature, a considerable rate of morbidity and mortality persists, mainly due to the complexity of its clinical presentations. Most cases correspond to primary headaches, such as migraine and tension-type headache, which, although rarely associated with death or permanent sequelae, constitute significant causes of functional disability. Secondary headaches, on the other hand, require immediate attention as they may represent potentially serious conditions. Thus, their early identification and exclusion are crucial before defining the appropriate clinical management. In this context, the present chapter aims to analyze the approach to headaches in emergency units, with an emphasis on the exclusion of secondary causes, as well as to discuss the proper management of primary headaches and strategies for their prevention, including patient education and prophylactic measures. This study consists of a narrative literature review, with searches conducted in the BVS, PubMed, and Google Scholar databases, considering publications from 2020 to 2025 without language restrictions. The final sample included 7 scientific articles, selected after applying inclusion and exclusion criteria. To systematize clinical reasoning, a diagnostic flowchart was developed, based on the most recent evidence, with the goal of optimizing the evaluation, diagnosis, and management of headaches within the emergency care setting.
- Alan Henrique Grecco Guedes
- Amanda Wohlenberg
- Felipe Bonadeo Abib
- Isabella Bobsin Borba