Clinical policy: Critical issues in the evaluation and management of adult patients presenting to the emergency department with acute headache
Clinical policy: Critical issues in the evaluation and management of adult patients presenting to the emergency department with acute headache
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DOI：
10.1016/j.annemergmed.2008.07.001
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发表时间：
2008-10-01
影响因子：
6.2
通讯作者：
Decker, Wyatt W.
中科院分区：
文献类型：
--
作者：
Edlow, Jonathan A.;Panagos, Peter D.;Decker, Wyatt W.
美国急诊医师学会的这一临床政策是对2002年的一项临床政策的更新，该政策是对急诊（ED）急性非创伤性头痛成年患者的评估和管理。一个写作小组委员会回顾了文献，得出基于证据的建议，以帮助临床医生回答以下5个关键问题：(1)我对治疗的反应能否预测所有急性头痛的病因(2)哪些头痛患者需要在急诊科进行神经影像学检查？(3)对于非创伤性蛛网膜下腔出血的ED患者，如果其非对比脑计算机断层扫描（CT）显示正常，是否需要常规进行腰椎穿刺？(4)在没有神经影像学研究的情况下，哪些以头痛为主诉的成年患者可以安全地进行腰椎穿刺？(5)突发性严重头痛患者CT和腰椎穿刺均阴性，是否需要进一步急诊诊断性影像学检查？证据被分级，并根据档案医学文献中现有数据的强度给出建议。
This clinical Policy from the American College of Emergency physicians is all Update of a 2002 clinical policy on the evaluation and management of adult patients presenting to the emergency department (ED) with acute, nontraumatic huadache. A writing subcummittee reviewed the literature to derive evidence-bascd recommendations to help clinicians answer the following 5 critical questions: (1) Does I response to therapy predict the etiology of all acute headache (2) Which patients with headache require neuroimaging in the ED? (3) Does lumbar puncture need to be routinely performed oil ED patients being worked LIP for nontraumatic subarachnoid hemorrhage whose noncontrast brain computed tomography (CT) scans are interpreted as normal? (4) In which adult patients with a complaint of headache call a lumbar puncture be safely performed without a neuroimaging study? (5) Is there a need for further emergent diagnostic imaging in the patient With sudden-onset, Severe headache who has negative findings In both CT and lumbar puncture? Evidence was graded and recommendations were given based on the Strength of the available data in File medical literature.