{
  "abstract": "Introduction Headaches comprise 8-14% of total presentations to acute services. Secondary headaches cause greater morbidity and mortality (1,2,3). A five-question tool previously showed utility in identifying secondary headache (1). We present a preliminary revalidation analysis with unilateral headache as an added feature.Methods A six-week retrospective review of headache patients attending neuro-SDEC at UCLH. Six parameters: thunderclap headache, focal neurological symptoms, focal neurological signs, systemic symptoms, unilateral headache, age greater than 50, were assessed. Multiple triggers of the tool were reviewed.Results 62 patients were included. 69% had primary headache & 31% had secondary headache. The tool positively identified 74% of secondary headache (sensitivity: 74%, specificity: 40%). With removal of the least specific question, focal symptoms, sensitivity was 69% & specificity 53%. Unilateral headache was not correlated to headache type. The most specific question was focal signs (specificity: 94%, accuracy: 76%). Multiple triggers improved specificity to 81%.Conclusion Focal symptoms had the least diagnostic utility with focal neurological signs the most. Unilateral headache had no additive effect. Multiple triggers improved specificity. Seasonal sinusitis prevalence may have contributed to secondary headache percentage. Further data collection to expand the cohort, correlation plot analysis, and modification for potential clinical use, is being undertaken.a.dethabrew@nhs.net",
  "authors": [
    {
      "affiliations": [
        "Neurology Same Day Emergency Care Service (neuro-SDEC), University College London Hospital (UCLH)",
        "Department of Neurology, National Hospital of Neurology and Neurosurgery (NHNN)"
      ],
      "name": "De Thabrew Agampodi Umanda"
    },
    {
      "affiliations": [
        "Neurology Same Day Emergency Care Service (neuro-SDEC), University College London Hospital (UCLH)",
        "Department of Neurology, National Hospital of Neurology and Neurosurgery (NHNN)"
      ],
      "name": "Shirazi Ayala"
    },
    {
      "affiliations": [
        "Neurology Same Day Emergency Care Service (neuro-SDEC), University College London Hospital (UCLH)",
        "Department of Neurology, National Hospital of Neurology and Neurosurgery (NHNN)"
      ],
      "name": "Spencer Jonathan"
    },
    {
      "affiliations": [
        "Neurology Same Day Emergency Care Service (neuro-SDEC), University College London Hospital (UCLH)",
        "Department of Neurology, National Hospital of Neurology and Neurosurgery (NHNN)"
      ],
      "name": "Macarimban-Inglesant Roberto"
    },
    {
      "affiliations": [
        "Neurology Same Day Emergency Care Service (neuro-SDEC), University College London Hospital (UCLH)",
        "Department of Neurology, National Hospital of Neurology and Neurosurgery (NHNN)"
      ],
      "name": "Alim-Marvasti Ali Jesus"
    },
    {
      "affiliations": [
        "Neurology Same Day Emergency Care Service (neuro-SDEC), University College London Hospital (UCLH)",
        "Department of Neurology, National Hospital of Neurology and Neurosurgery (NHNN)"
      ],
      "name": "Balaratnam Michelle"
    },
    {
      "affiliations": [
        "Neurology Same Day Emergency Care Service (neuro-SDEC), University College London Hospital (UCLH)",
        "Department of Neurology, National Hospital of Neurology and Neurosurgery (NHNN)"
      ],
      "name": "Turner Chris"
    },
    {
      "affiliations": [
        "Department of Neurodegenerative Disease, University College London"
      ],
      "name": "Shoai Maryam"
    },
    {
      "affiliations": [
        "Department of Neurology, National Hospital of Neurology and Neurosurgery (NHNN)",
        "Pain Management Centre, NHNN"
      ],
      "name": "Bahra Anish"
    },
    {
      "affiliations": [
        "Neurology Same Day Emergency Care Service (neuro-SDEC), University College London Hospital (UCLH)",
        "Department of Neurology, National Hospital of Neurology and Neurosurgery (NHNN)"
      ],
      "name": "Haider Salman"
    }
  ],
  "title": "119 Evaluation of modified five-question tool in predicting secondary headache",
  "uid": "207ef103-e155-5ff7-8725-45a36af5b3c8"
}