Acute Migraine Pathway: Headache Cocktail Decision Support
PATHWAYMigraine Pathway
STEP 1 · SAFETY SCREEN
Red Flags
Identify high-risk headaches requiring urgent diagnostic workup (CT/CTA/LP/MRI) before symptomatic treatment.
STEP 2 · TRIAGE
Awaiting Step 1 ↑
STEP 3 · ACUTE TX
Awaiting Step 2 ↑
STEP 4 · RESPONSE
Awaiting Step 3 ↑
STEP 5 · PLAN
Awaiting Step 4 ↑
DECISION SUPPORT ONLY
Based on Robblee et al. 2025 AHS ED Guideline (Headache 2026;66:53–76, DOI 10.1111/head.70016) for ED parenteral therapy and Ailani et al. AHS 2021 Consensus (Headache 2021;61:1021–1039, DOI 10.1111/head.14153) for outpatient acute selection. Continuum 2024 chapters (Burch acute, Burish cluster, Rizzoli MOH, Goadsby indomethacin, Nahas neuralgias) inform special-population and differential-diagnosis branches. Individual patient factors (allergies, interactions, pregnancy stage) must be verified by the treating clinician.