In these low risk patients it is safe to forego further imaging such as echo venography of the lower limbs or pulmonary spiral CT. When low risk Wells score patients have a normal D-dimer, the post-test probability of DVT or PE is 0.5–2 % when using a sensitive ELISA quantative assay. The score includes clinical signs of DVT, PE being the most likely diagnosis, heart rate over 100 bpm, recent immobility or surgery, hemoptysis, previous PE or DVT or the presence of malignancy, Each item in the Wells score has a rating and patients with 1.5 point or less are rated low risk for PE. The Wells score for PE is calculated based on clinical parameters and patient history. Clinical factors are translated to the Wells score, ranking patients to high or low risk categories. ĭ-dimers have been proven useful in the diagnosis of pulmonary embolism (PE) and deep venous thrombosis (DVT). Patients with isolated headache seem to have a good prognosis, however, CVT patients with isolated headache who present early (<7 days) are more at risk to deteriorate neurologically than patients with isolated headache who present later, making diagnosis in an early stage important. It may present with headache alone in 14 % and acute headache in 3–13 % of cases. CVT is accompanied by headache in 89 % of cases. It is vital to exclude secondary forms of headache requiring further treatment such as cerebral venous thrombosis (CVT). Headache frequently leads to emergency room consultation.

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