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Papers of the Week

2022 Feb 10

Emerg Med J

Thunderclap headache syndrome presenting to the emergency department: an international multicentre observational cohort study.


Roberts T, Horner DE, Chu K, Than M, Kelly A-M, Klim S, Kinnear F, Keijzers G, Karamercan M A, Wijeratne T, Kamona S, Sen Kuan W, Graham CA, Body R, Laribi S
Emerg Med J. 2022 Feb 10.
PMID: 35144978.


Most headache presentations to emergency departments (ED) have benign causes; however, approximately 10% will have serious pathology. International guidelines recommend that patients describing the onset of headache as 'thunderclap' undergo neuroimaging and further investigation. The association of this feature with serious headache cause is unclear. The objective of this study was to determine if patients presenting with thunderclap headache are significantly more likely to have serious underlying pathology than patients with more gradual onset and to determine compliance with guidelines for investigation.