• Kinley Roberts, Linda Harrington, and Sinéad M Murphy.
• Department of Neurology, Tallaght University Hospital, Dublin 24, Ireland. kinley.roberts@nrh.ie.
• Ir J Med Sci. 2021 Aug 1; 190 (3): 1143-1148.

BackgroundHeadache is the most common reason for referral to neurology outpatient clinics in Ireland and represents approximately 30% of all new appointments.AimTo evaluate diagnoses and outcomes of all patients newly referred with headache to a consultant neurologist at an Irish university teaching hospital over a 2-year period.DesignA retrospective analysis and audit.MethodsData including patient demographics, red flags, investigations, diagnosis, and outcome were collected on consecutive patients newly referred with headache to a consultant neurologist's outpatient clinic over a 2-year period.ResultsTwo hundred and seventy patients with headache were seen; 75% were women with mean age of 39 years. 89.26% (241/270) were diagnosed with a primary headache disorder alone; 4.44% (12/270) with a secondary headache disorder alone; 3.33% (9/270) with both a primary and secondary headache disorders; and 2.96% (8/270) with a painful cranial neuropathy. Migraine was the most common diagnosis, frequently associated with medication overuse. Non-attendance rates were high. Although imaging abnormalities were frequently found, on no occasion was it thought to be the cause of the headache.ConclusionsMost patients referred to a neurology outpatient clinic with headache have a primary headache disorder. Alternate pathways should be considered to reduce the burden on Ireland's limited neurology resources without compromising patient safety.© 2020. Royal Academy of Medicine in Ireland.

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