Acil Serviste Sekonder Tip Baş Ağrı Tanılı Hastalarda Ağrı Karakteri ile Radyolojik Görüntüleme Bulgularının Karşılaştırılmalı Olarak Değerlendirilmesi; Prospektif Analiz
Abstract
Amaç: Sekonder tip baş ağrıları acil serviste %4-5 oranında gözlenir. Bu çalışmada sekonder tip baş ağrısı olan hastalarda ağrı karakterinin radyolojik görüntüleme bulguları ile değerlendirildiğinde hastaların konsültasyon, yatış, taburculuk kararı gibi ortaya çıkan sonuçlarının prospektif olarak değerlendirilmesi amaçlandı.
Gereç ve Yöntemler: Bu, tek merkezli, prospektif ve metodolojik bir çalışmadır. International Headache Society kriterlerine göre sekonder tipte baş ağrısı olan toplamda 200 hastanın sosyo-demografik özellikleri, acil servise başvuru muayene bulguları ve tetkik sonuçları kayıt altına alındı.
Bulgular: Hastaların %50’sinde zonklayıcı tipte, %29.5’inde sıkıştırıcı tipte ağrı mevcuttu ve sıkıştırıcı tipte ağrısı olan hastalarda BT’de patolojik bulgu saptanma oranı anlamlı oranda daha yüksek idi (p=0.019). Konsültasyon istenen hastaların yatış oranı anlamlı oranda daha yüksek idi ve yatış kararı verilen hastaların %69.0’ında sıkıştırıcı karakterde ağrı mevcuttu (p<0.05).
Sonuç: Baş ağrısı ile acil servise başvuran hastalarda sekonder tip baş ağrısı tanısında ağrı karakterlerinin dikkatle sorgulanmasının, radyolojik görüntüleme endikasyonlarının iyi değerlendirilmesinin gerektiğinde diğer klinikler ile işbirliği içinde çalışılmasının hasta adına daha hızlı ve doğru karar verilmesinde önemli rol oynadığı gözlendi.
References
- Bıçakcı Ş, Öztürk M, Üçler S, Karlı N, Siva A. Türk Nöroloji Derneği Başağrısı Çalışma Grubu Uygulamaları. Türk Nöroloji Derneği Yayınları 2018 İstanbul. Galenos Publishing Company, 2018. ISBN: 978-605-89294-7-0
- Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd-Edition-2018. Cephalal gia. 2018;38(1):1-211.
- Chu KH, Howell TE, Keijzers G, Furyk JS, Eley RM, Kinnear FB, et al. Acute headache presentations to the emergency department: A statewide cross-sectional study. Acad Emerg Med. 2017;24(1):53-62.
- Rasmussen BK, Jensen R, Olesen J. A population-based analysis of the diagnostic criteria of the International Headache Society. Cephalalgia. 1991;11(3):129-34.
- American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Acute Headache:, Godwin SA, Cherkas DS, Panagos PD, Shih RD, Byyny R, Wolf SJ. Clinical Policy: Critical issues in the evaluation and management of adult patients presenting to the emergency department with acute headache. Ann Emerg Med. 2019;74(4):e41-e74
- Fisch BJ, Pedley TA. evaluation of focal cerebral lesions. Role of electroencephalography in the era of computed tomography. Neurol Clin. 1985;3(3):649-62
- John G. Edmeads, Shuu-Jiun Wang. Headaches in the elderly. The Headaches 3rd Edition. Jesolesen, Peter J. Goadsby, Nabih M. Ramadan, Peer Tfelt- hansen, K. Micheal A. Welch. LW&W Philadelphia 2006, 1105-10
- Barton CW. Evaluation and treatment of headache patients in the emergency department: A survey. Headache. 1994;34(2):91-4.
- Newman LC, Lipton RB. Emergency department evaluation of headache. Neurol Clin. 1998;16(2):285-303.
- Doretti A, Shestaritc I, Ungaro D, Lee JI, Lymperopoulos L, Kokoti L, et al: School of Advanced Studies of the European Headache Federation (EHF-SAS). Headaches in the emergency department-a survey of patients' characteristics, facts and needs. J Headache Pain. 2019;20(1):100.
- Türk Başağrısı Epidemiyoloji Çalışma Grubu.Headache Screening Survey. Piar-Gallup, Marketing Research Co, İstanbul, s.1-53, September 1997.
- Gupta, Reshu, et al. Clinical characteristics of a severe headache and its impact on personal life of patients. Int J Cur Res Rev| 2021;13(10):95-100.
- Kelly AM, Kuan WS, Chu KH, Kinnear FB, Keijzers G, Karamercan MA, et al; and the HEAD Study Group. Epidemiology, investigation, management, and outcome of headache in emergency departments (HEAD study)-A multinational observational study. Headache. 2021;61(10):1539-52.
- Aygun D, Bildik F. Clinical warning criteria in evaluation by computed tomography the secondary neurological headaches in adults. Eur J Neurol. 2003;10(4):437-42
- Isler H, Historical Background. In: Olesen J, Tfelt- Hansen P, Welch KMA (eds): The Headaches. New York: Raven Pres, 1993, p1-8.
COMPARATIVE EVALUATION OF PAIN CHARACTERISTICS AND RADIOLOGICAL IMAGING FINDINGS IN PATIENTS WITH SECONDARY TYPE HEADACHE IN THE EMERGENCY DEPARTMENT; A PROSPECTIVE ANALYSIS
Abstract
Objective: Secondary type headache is observed at a rate of 4-5% in the emergency department. In this prospecitve study, it was aimed to evaluate the results of patients with secondary headache, such as consultation, hospitalization, and discharge decision in correlation with radiological imaging findings.
Material and Methods: This is a single-center, prospective and methodological study. According to International Headache Society criteria, sociodemographic characteristics, emergency department examination findings of a total of 200 patients with secondary headache were recorded.
Results: Fifty percent of the patients had throbbing pain, 29.5% had constrictive pain, and the rate of pathological findings on CT was significantly higher in patients with squeezing pain (p=0.019). The hospitalization rate was significantly higher in the patients for whom consultation was requested, and 69.0% of the patients who were admitted to the hospital had constrictive pain (p<0.05).
Conclusion: It has been observed that careful questioning of pain characteristics, good evaluation of radiological imaging indications, and working in cooperation with other clinics when necessary in the diagnosis of secondary type headache in patients presenting to the emergency department with headache play an important role in making faster and more accurate decisions on behalf of the patient.
References
- Bıçakcı Ş, Öztürk M, Üçler S, Karlı N, Siva A. Türk Nöroloji Derneği Başağrısı Çalışma Grubu Uygulamaları. Türk Nöroloji Derneği Yayınları 2018 İstanbul. Galenos Publishing Company, 2018. ISBN: 978-605-89294-7-0
- Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd-Edition-2018. Cephalal gia. 2018;38(1):1-211.
- Chu KH, Howell TE, Keijzers G, Furyk JS, Eley RM, Kinnear FB, et al. Acute headache presentations to the emergency department: A statewide cross-sectional study. Acad Emerg Med. 2017;24(1):53-62.
- Rasmussen BK, Jensen R, Olesen J. A population-based analysis of the diagnostic criteria of the International Headache Society. Cephalalgia. 1991;11(3):129-34.
- American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Acute Headache:, Godwin SA, Cherkas DS, Panagos PD, Shih RD, Byyny R, Wolf SJ. Clinical Policy: Critical issues in the evaluation and management of adult patients presenting to the emergency department with acute headache. Ann Emerg Med. 2019;74(4):e41-e74
- Fisch BJ, Pedley TA. evaluation of focal cerebral lesions. Role of electroencephalography in the era of computed tomography. Neurol Clin. 1985;3(3):649-62
- John G. Edmeads, Shuu-Jiun Wang. Headaches in the elderly. The Headaches 3rd Edition. Jesolesen, Peter J. Goadsby, Nabih M. Ramadan, Peer Tfelt- hansen, K. Micheal A. Welch. LW&W Philadelphia 2006, 1105-10
- Barton CW. Evaluation and treatment of headache patients in the emergency department: A survey. Headache. 1994;34(2):91-4.
- Newman LC, Lipton RB. Emergency department evaluation of headache. Neurol Clin. 1998;16(2):285-303.
- Doretti A, Shestaritc I, Ungaro D, Lee JI, Lymperopoulos L, Kokoti L, et al: School of Advanced Studies of the European Headache Federation (EHF-SAS). Headaches in the emergency department-a survey of patients' characteristics, facts and needs. J Headache Pain. 2019;20(1):100.
- Türk Başağrısı Epidemiyoloji Çalışma Grubu.Headache Screening Survey. Piar-Gallup, Marketing Research Co, İstanbul, s.1-53, September 1997.
- Gupta, Reshu, et al. Clinical characteristics of a severe headache and its impact on personal life of patients. Int J Cur Res Rev| 2021;13(10):95-100.
- Kelly AM, Kuan WS, Chu KH, Kinnear FB, Keijzers G, Karamercan MA, et al; and the HEAD Study Group. Epidemiology, investigation, management, and outcome of headache in emergency departments (HEAD study)-A multinational observational study. Headache. 2021;61(10):1539-52.
- Aygun D, Bildik F. Clinical warning criteria in evaluation by computed tomography the secondary neurological headaches in adults. Eur J Neurol. 2003;10(4):437-42
- Isler H, Historical Background. In: Olesen J, Tfelt- Hansen P, Welch KMA (eds): The Headaches. New York: Raven Pres, 1993, p1-8.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Özgün Araştırma |
| Authors | |
| Publication Date | August 31, 2023 |
| Submission Date | April 28, 2023 |
| Published in Issue | Year 2023 Volume: 25 Issue: 2 |
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Bu Dergi, Kırıkkale Üniversitesi Tıp Fakültesi Yayınıdır.