Research Article| Volume 3, ISSUE 4, P216-221, 1993

Headache characteristics in aneurysmal subarachnoid hemorrhage

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      To investigate the nature of the headache accompanying aneurysmal subarachnoid hemorrhage, a retrospective study was conducted. Fifty-four patients and 54 controls completed questionnaires regarding headache, medical history, and family history, in an attempt to derive further information regarding symptoms and factors that might be predictive of aneurysmal subarachnoid hemorrhage. Factors that appear to be of importance in evaluating headache caused by subarachnoid hemorrhage include ominously severe headache, a history of vigorous physical activity precipitating headache, syncope or transient lethargy accompanying headache, previous medical attention for headache, a family history of aneurysmal subarachnoid hemorrhage, or catastrophic central nervous system event at an early age. An algorithm for the management of serious headache is suggested.

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        • Sypert GW
        Intracranial aneurysm: natural history and surgical management.
        Compr Ther. 1978; 4: 64-73
        • Garraway WM
        • Whisnant JP
        • Furlan AJ
        • et al.
        The declining incidence of stroke.
        N Engl J Med. 1979; 300: 449-452
        • Kassell NF
        • Drake CG
        Timing of aneurysm surgery.
        Neurosurgery. 1982; 10: 514-519
        • Knaus WA
        • Wagner DP
        • Davis DO
        CT for headache: cost/benefit for subarachnoid hemorrhage.
        AJR. 1981; 136: 537-542
        • Day AL
        • Salcman M
        Subarachnoid hemorrhage.
        Am Fam Physician. 1989; 40: 95-105
        • Hunt WE
        • Hess RM
        Surgical risks as related to time of intervention in repair of intracranial aneurysms.
        J Neu-rosurg. 1968; 28: 14-20
        • Leblanc R
        • Winfield JA
        The warning leak in subarachnoid hemorrhage and the importance of its early diagnosis.
        Can Med Assoc J. 1984; 131: 1235-1236
        • Ljunggren B
        • Saveland H
        • Brandt L
        • et al.
        Aneurysmal subarachnoid hemorrhage. Total annual outcome in a 1.46M population.
        Surg Neurol. 1984; 22: 435-438
        • Sacco RL
        • Wolf PA
        • Bharucha NE
        • et al.
        Subarachnoid intracerebral hemorrhage.
        Neurology. 1984; 34: 847-854
      1. Gorelick PB,Greenberg MS. Three cases: clinical clues and red herrings. Hosp Pract 8/15/87;245-54.

        • Dinning TAR
        • Falconer MA
        Sudden or unexplained death due to ruptured intracranial aneurysm. Survey of 250 forensic cases.
        Lancet. 1953; 2: 799-801
        • Okawara S-H
        Warning signs prior to rupture of intracranial aneurysm.
        J Neurosurg. 1973; 38: 575-580
        • King RB
        • Saba MI
        Forewarningsofmajorsubarachnoid hemorrhage due to congenital berry aneurysm.
        NY State J Med. 1974; 74: 638-639
        • Ljunggren B
        • Brandt L
        • Saveland H
        • et al.
        Outcome in 60 consecutive patients treated with early aneurysm operation and intraventricular nimodipine.
        J Neurosurg. 1984; 61: 864-873
        • Calvert JM
        Premonitory symptoms and signs of subarachnoid hemorrhage.
        Med J Aust. 1966; 53: 651-657
        • Day JW
        • Raskin NH
        Thunderclap headache: symptom of unruptured cerebral aneurysm.
        Lancet. 1986; 2: 1247-1248
        • Jain KK
        Headache in relation to intracranial aneurysm.
        Headache. 1967; 7: 122-126
        • Leblanc R
        The minor leak preceding subarachnoid hemorrhage.
        J Neurosurg. 1987; 66: 35-39
        • Verweij RD
        • Wijdicks EFM
        • Gijn J Van
        Warning headache in aneurysmal subarachnoid hemorrhage: a case-control study.
        Arch Neurol. 1988; 45: 1019-1020
        • Waga S
        • Ohrubo K
        • Handa H
        Warning signs in intracranial aneurysms.
        Surg Neurol. 1975; 3: 15-20
        • Ball MJ
        Pathology of the “sentinel headache” before berry aneurysm rupture.
        Can Med Assoc J. 1975; 112: 78-79
        • Markus HS
        A prospective follow-up of thunderclap headache mimicking subarachnoid hemorrhage.
        J Neurol Neurosurg Psychiatry. 1991; 54: 1117-1118
        • Harling DW
        • Peatfield RC
        • VanHille PT
        • Abbott RJ
        Thunderclap headache: is it migraine?.
        Cephalalgia. 1989; 9: 87-90
        • Hauerberg GJ
        • Andsersen BB
        • Eskesen V
        • Rosenorn J
        • Schmidt K
        Importance of the recognition of a warning leak as a sign of a ruptured intracranial aneurysm.
        Acta Neurol Scand. 1991; 83: 61-64
        • Andreoli TE
        • Carpenter CCJ
        • Plum F
        • Smith Jr., LH
        Cecil essentials of medicine. 2nd ed. Saunders, Philadelphia1990 (708–12)
        • Hillman J
        Should computerized tomography replace LP in the diagnosis of suspected subarachnoid hemorrhage?.
        Surg Neurol. 1986; 26: 547-550
        • Loftus CM
        Current diagnosis and management of subarachnoid hemorrhage of all causes.
        Neurosurg Quart. 1992; 2: 44-58