Abstract
Objective: To analyze the primary headache type, medical treatments initiated, and imaging characteristics of patients referred to neurology outpatient clinics from the emergency department.
Methodology: Patients referred to neurology outpatient clinics from the emergency department between January 2014 and January 2024 were included in the study. Demographic data and case information were obtained from the hospital database.
Results: The study included 6940 primary headache patients. Of the patients included in the study, 4164 (60%) were female and 2776 (40%) male. The mean age was 36.02±15.21 years. The most common headache in female patients was migraine, and in male patients, it was a tension-type headache. The proportions of patients who underwent one, two, three, or more cranial imaging procedures in the emergency department within 10 years were 20%, 35%, and 45%, respectively. Eletriptan was the most used drug in the treatment of migraine attacks in 37.8%, Amitriptyline was used in 32.8% of patients for migraine prophylaxis and duloxetine was used in 31.1% of patients for tension-type headaches.
Conclusion: The management of primary headaches remains a challenge for primary care physicians. In a patient with severe pain, both medical history and neurologic examination are time-consuming. Considering the patient density and fast pace of work in the emergency department, misdiagnosis and analgesic treatments administered at every emergency department visit without considering the patient's past information delays the prophylactic treatment process in primary headaches and make treatment difficult.

Key words: Headache, migraine, tension headache, cluster headache, emergency department.