Document Detail


Prospective study of sentinel headache in aneurysmal subarachnoid haemorrhage.
MedLine Citation:
PMID:  7914965     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Retrospective surveys of patients with subarachnoid haemorrhage suggest that minor episodes with sudden headache (warning leaks) may precede rupture of an aneurysm, and that early recognition and surgery might lead to improved outcome. We studied 148 patients with sudden and severe headache (possible sentinel headache) seen by 252 general practitioners in a 5-year period in the Netherlands. Subarachnoid haemorrhage was the cause in 37 patients (25%) (proven aneurysm in 21, negative angiogram in 6, no angiogram done in 6, sudden headache followed by death in 4). 103 patients had headache as the only symptom, 12 of whom proved to have subarachnoid haemorrhage (6 with a ruptured aneurysm). Previous bouts of sudden headache had occurred in only 2. Other serious neurological conditions were diagnosed in 18. In the remaining 93, no underlying cause of headache was found; follow-up over 1 year showed no subsequent subarachnoid haemorrhage or sudden death. In this cohort, acute, severe headache in general practice indicated a serious neurological disorder in 37% (95% CI 29-45%), and subarachnoid haemorrhage in 25% (18-32%). 12% (5-18%) of those with headache as the only symptom. The notion of warning leaks as a less serious variant of subarachnoid haemorrhage is not supported by this study. Early recognition of subarachnoid haemorrhage is important but will probably have only limited impact on the outcome in the general population.
Authors:
F H Linn; E F Wijdicks; Y van der Graaf; F A Weerdesteyn-van Vliet; A I Bartelds; J van Gijn
Related Documents :
12193135 - Oral administration of an inhibitor of endothelin-converting enzyme attenuates cerebral...
12111635 - Churg-strauss syndrome presenting as spontaneous subarachnoid haemorrhage.
8844785 - Effect of deferoxamine and sympathectomy on vasospasm following subarachnoid hemorrhage.
7836675 - Intra-arterial papaverine for the treatment of cerebral vasospasm after subarachnoid he...
11524355 - The relationship between pneumatic tourniquet time and the amount of pulmonary emboli i...
454995 - Assessment of carotid artery stenosis using pulse wave transit time.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Lancet     Volume:  344     ISSN:  0140-6736     ISO Abbreviation:  Lancet     Publication Date:  1994 Aug 
Date Detail:
Created Date:  1994-09-22     Completed Date:  1994-09-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  590-3     Citation Subset:  AIM; IM    
Affiliation:
University Department of Neurology, Utrecht, Netherlands.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Acute Disease
Carotid Artery Diseases / complications,  diagnosis
Female
Headache / etiology*
Humans
Intracranial Aneurysm / complications*
Male
Prospective Studies
Rupture, Spontaneous
Subarachnoid Hemorrhage / complications*,  diagnosis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Insulin resistance as the major cause of impaired glucose tolerance: a self-fulfilling prophesy?
Next Document:  Hormonal modulation of atrial natriuretic factor receptors and effects on adrenal glomerulosa cells ...