C Reactive Protein and the diagnosis of intracranial infection.

Report By: Amy Au-Yong - Medical Student
Search checked by Professor Tim Coats - Professor of Emergency Medicine
Institution: Emergency Department, Leicester Royal Infirmary
Date Submitted: 22nd August 2006
Date Completed: 13th March 2007
Last Modified: 18th January 2007
Status: Green (complete)

Three Part Question

In [adult patients presenting as an emergency with headache] does [a normal CRP measurement] [exclude a diagnosis of intracranial infection]?

Clinical Scenario

A 25 year old woman presents to the emergency department with acute headache. You wonder whether a C Reactive Protein (CRP) measurement will help in excluding the diagnosis of intracranial infection.

Search Strategy

Medline 1950 - January 2007 using the OVID interface
[exp headache OR headache$.mp] AND [Exp C Reactive Protein OR crp.mp OR (c adj reactive adj protein).mp] LIMIT TO humans and English language

Search Outcome

Altogether 62 papers were found. None were relevant.

Comment(s)

Acute headache is a common presentation to the emergency department. Intracranial infection is a rare cause of headache but if this diagnosis is missed it can be disastrous for the patient. There is no evidence for or against the use of C Reactive Protein as a diagnostic tool to rule in or rule out intracranial infection.

Clinical Bottom Line

There is no evidence for or against the use of C Reactive Protein as a diagnostic tool in the diagnosis of intracranial infection in patients presenting to the Emergency Department with headache.