Should An Acute Headache Service Be Part Of A Headache Clinic?

Abstract

Abstract Academic acute headache services and headache clinics have three common missions: (1) to provide the best possible clinical care to headache patients; (2) to teach young physicians about headaches; and (3) to initiate and participate in headache research programmes. However, these two types of services differ in a number of things. The former provides emergency management to patients with any type of acute headache regardless of the cause, whereas the latter provides multidisciplinary management and long-term follow-up to patients who are mainly affected by episodic or chronic primary headaches. Concerning practical teaching, an acute headache service is a unique tool. Owing to its large recruitment area and to the high number of patients seen every day, such a service gives interns and fellows the opportunity to become familiar with almost all primary and secondary headache forms within a few weeks. In headache clinics, practical teaching may be more focused on diagnosis and treatment of primary headaches. Finally, an acute headache service may offer the opportunity to set up specific research programmes focused on some infrequent secondary headache disorders, on diagnosis strategies and procedures, and on acute pain-relieving treatments. On the other hand, headache clinics may be more involved in therapeutic trials of both abortive and preventive headache treatments.