Does intravenous magnesium improve outcomes for patients with acute non-traumatic headache in the emergency department? This review of a randomised trial examines the size of the analgesic benefit, adverse effects and whether a statistically positive result is enough to change practice.
JC: Magnesium for Acute Headache: Maybe, but perhaps not for all.. Read More
A 2020 appraisal of intravenous haloperidol for acute benign headache. The review considers pain relief, adverse effects and patient selection, asking whether a placebo-controlled trial can tell us enough when the useful clinical comparison would be with usual headache treatment.
JC: Haloperidol for Headaches. St Emlyn’s Read More
Does tranexamic acid improve recovery after spontaneous intracerebral haemorrhage? This 2018 appraisal of TICH-2 examines death and dependence, haematoma expansion and the uncertainty around the results. It explores why a possible effect on bleeding does not necessarily establish a meaningful improvement in patients’ longer-term outcomes.
JC: TICH TICH BOOM? TXA in ICH. St Emlyn’s Read More
Can the Ottawa subarachnoid haemorrhage rule reduce unnecessary investigation without missing serious disease? This 2017 appraisal examines its prospective validation, patient selection and the tradeoff between sensitivity and specificity. Natalie May considers testing burden, clinician interpretation and why careful documentation of headache onset matters.
JC: Subarachnoid Haemorrhage, Decision Rules & Overtesting Headaches Read More
When might an early CT scan change the need for lumbar puncture in suspected subarachnoid haemorrhage? This 2016 discussion reviews the evidence available then, scanner and reporting requirements, and conversations with patients about uncertainty, further investigation and the risks of testing.
Let’s talk about subarachnoid haemorrhage Read More
A 2014 learning guide to headache in the emergency department, with a podcast, self-test and further resources. It explores concerning features in the history, neurological examination and decisions about investigations, emphasising discussion with senior colleagues when serious causes remain a concern.
Headache in the Emergency Department Read More
Could propofol have a role in refractory migraine? This 2013 journal club critiques an eight-patient case series, examining unclear recruitment, pain measurement during sedation and why larger, better-designed studies would be needed before drawing conclusions for practice.
JC: Milk for refractory migraines? Read More
More scans do not necessarily mean more useful diagnoses. This 2012 journal club examines US trends in CT and MRI for atraumatic headache, questioning coding accuracy, survey extrapolation and what the findings can tell clinicians about assessing an individual patient.
JC: Trends in CT/MRI for Atraumatic Headache in the US Read More
