Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Headache

Use the Ottawa Subarachnoid Hemorrhage Rule ≥40 years, complaint of neck pain or stiffness, witnessed loss of consciousness, onset with exertion, thunderclap headache, and limited neck flexion on examination) as a decision rule that has high sensitivity to rule out SAH, but low specificity to rule in SAH, for patients presenting to the ED with a normal neurologic examination result and peak headache severity within 1 hour of onset of pain symptoms. (B)