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Objective: To examine the utility of features in detecting underlying causes of headache in patients presenting to an emergency room. Study Design: Descriptive Observational Study. Place and Duration of Study: Pakistan Railway Hospital spanning over a period of one year from Judy 2010 to June2011. Materials and Methods: Medical records of the patients attending the Emergency Room with headache as the major complaint were studied Results: 312 patients presented to ER with a complaint of headache. Of these 7.7% (n—24) had malignant headache and 92.3% (n=288) had benign headache. One hundred and ninety six patients (62.8%) were women and 116(372%) were men. In males there were 86.2% patients with benign headache and 138% with malignant headache. While in females 94.9% had benign and 4.1% malignant headache. Ninety percent of patients had altered consciousness at presentation proved to have malignant cause for their headache. This figure was 91 % for limb weakness, 100% fcr papillary and gaze abnormalities, 89% for extensor plantar response, and 85% each for papilledema and neck rigidity. Conclusions: Females present at age with headache and tend to have benign than malignant headache in majority Of cases. Males present at relatively older age and tend to have malignant than benign headache in majority Of cases. Younger patients presenting With headache usually have benign and elderly patients usually have malignant illness as the cause of their headache. With a good history and thorough examination Imagng like CT Scan and MRI can be avoided.

Mohammad Masood Savul, Iffat Sultana, Asim Zulfiqar, Lubna Meraj. (2012) Headache: A Useful Clinical Feature in Detecting Serious Underlying Cause, Journal of Islamic International Medical College, Volume-7, Issue-2.
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