The main objective of this pilot study is to make a first assessment of the discriminating ability of a dosage of S100B protein for differential diagnosis between primary headaches and secondary headaches. For this, the investigators will compare serum S100B protein between two groups of headache patients presenting at the emergency department: 1 group of primary headache patients and 1 group of secondary headache patients. If the difference between the two groups proves potentially discriminating, the investigators will seek to determine the discriminating ability of the S100B protein by calculating the area under the ROC curve. The reference diagnostic will be set at one month across the entire clinical picture and imaging by an expert committee composed of a neurologist, a radiologist and an emergency physician.
The secondary objectives of this study are: A. To seek an association between S100B protein levels and the onset of pain depending on whether it is more or less than 3 hours. B. To assess the association between S100B protein levels and mortality at day 28. C. To evaluate the association between S100B protein levels and hospital care: average length of stay in the emergency department, lumbar puncture, brain imaging, average length of hospital stay. D. To evaluate the prognostic value of determination of S100B protein on the occurrence of a secondary headache at 1 month.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
81
Patients will have blood drawn to measure plasma S100B levels at inclusion.
If not performed under emergency conditions, patients will have an MRI on days 2-4.
CHRU de Nîmes - Hôpital Universitaire Carémeau
Nîmes, France
S100B protein level (ng/ml)
Time frame: Day 0
The presence/absence of a clinically significant anomaly on the MRI scan
Time frame: Days 2-4
Final diagnostic as established by an expert committee
The diagnostic posed is either "primary headache" or "secondary headache"
Time frame: Month 1
Mortality (yes/no)
"Mortality" refers to whether or not the subject is still alive.
Time frame: Month 1
Length of stay in the emergency department (days)
Time frame: Month 1
Length of stay in the hospital (days)
Time frame: Month 1
White blood cell count in cerebral spinal fluid
Time frame: Month 1
Red blood cell count in cerebral spinal fluid
Time frame: Month 1
Cerebral spinal fluid glucose level
Time frame: Month 1
Cerebral spinal fluid protein level
Time frame: Month 1
Cerebral spinal fluid chloride level
Time frame: Month 1
Presence/absence of enterovirus in cerebral spinal fluid
Based on qualitative result from ELISA laboratory exam.
Time frame: Month 1
Presence/absence of herpes virus in cerebral spinal fluid
Based on qualitative result from ELISA laboratory exam.
Time frame: Month 1
Presence/absence of cerebral imaging indicating an ischemic or hemorrhagic stroke, subarachnoid hemorrhage, an expansive process, cerebral trombophlebitis cerebral or other abnormalities suggestive of a secondary cause of headache.
Time frame: Month 1
Secondary headache onset: yes/no
Was there secondary headache onset by month 1?
Time frame: Month 1
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