# Headache Assessment of Children for Emergent Intracranial Abnormalities

> **NIH NIH R01** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2022 · $160,200

## Abstract

Project Summary
Annually, over 400,00 children present to emergency departments (EDs) across the U.S. with headaches as
their chief complaints. Although a small proportion (0.5-1%) of these children will have brain abnormalities
requiring emergent identification, such as tumors, bleeding, or strokes, a much larger proportion undergo
neuroimaging of the brain in the ED. Approximately, one-third of children with headaches are receiving
unnecessary imaging that increases their exposure to risk associated with neuroimaging. The goal of the
Headache Assessment of Children for Emergency Intracranial Abnormalities (HEADACHE) study is to
generate definitive evidence that will aid clinicians in determining risk of emergent intracranial abnormality to
help identify need for neuroimaging. The primary aim of HEADACHE is to derive and internally validate a
decision tool that stratifies the risk for children presenting to EDs with headaches. HEADACHE is a prospective
multicenter study planning to enroll 28,000 children 2-17 years old with headaches presenting to one of 18 EDs
in the Pediatric Emergency Care Applied Research Network (PECARN). Follow-up for children with headache
is essential for providing optimal symptom management and ensuring that necessary diagnostics or
consultations are obtained, particularly if neuroimaging is not obtained in the ED. Few data exist, however, to
determine whether disparities exist in accessing timely follow-up for children with headaches evaluated in EDs.
Timely follow up can include primary care provider (PCP) follow-up, neurology follow-up or outpatient
neuroimaging if indicated. This diversity supplement will enhance the HEADACHE study by gaining an in-depth
understanding of the barriers and challenges experienced by caregivers of children with headaches when
seeking follow-up care for their children after the initial ED visit. The specific aims of this diversity supplement
are: (1) to determine whether insurance status and/or race/ethnicity are independently associated with the time
to and rate of recommended follow-up to see a PCP or a neurologist, (2) to determine whether insurance
status and/or race/ethnicity are independently associated with obtaining neuroimaging and the type of
neuroimaging obtained after ED discharge, and (3) to quantitatively and qualitatively explore the caregivers'
lived experiences to identify barriers to timely PCP or neurology follow-up among underinsured/publicly insured
and/or racial/ethnic minoritized children presenting to the ED with headaches.

## Key facts

- **NIH application ID:** 10559250
- **Project number:** 3R01NS110826-03S1
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Daniel Sing-Kwong Tsze
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $160,200
- **Award type:** 3
- **Project period:** 2020-09-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10559250

## Citation

> US National Institutes of Health, RePORTER application 10559250, Headache Assessment of Children for Emergent Intracranial Abnormalities (3R01NS110826-03S1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10559250. Licensed CC0.

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