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Warning headache in aneurysmal subarachnoid hemorrhage. A case-control study.

R D Verweij1, E F Wijdicks, J van Gijn

  • 1University Department of Neurology, Utrecht, the Netherlands.

Archives of Neurology
|September 1, 1988
PubMed
Summary

Sudden headaches preceding aneurysmal subarachnoid hemorrhage (SAH) occurred in 43% of patients. Early recognition of these warning headaches is crucial for timely intervention and potentially improving outcomes in SAH cases.

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Area of Science:

  • Neurology
  • Neurosurgery
  • Emergency Medicine

Background:

  • Subarachnoid hemorrhage (SAH) is a critical neurological emergency.
  • Sudden onset headaches can be a symptom of serious underlying conditions.
  • Identifying warning signs for SAH is vital for prompt medical attention.

Purpose of the Study:

  • To investigate the prevalence and characteristics of warning headaches in patients with aneurysmal subarachnoid hemorrhage (SAH).
  • To compare the occurrence of warning headaches in SAH patients versus ischemic stroke patients and controls.
  • To assess the interval between warning headaches and SAH rupture and its impact on patient outcomes.

Main Methods:

  • A prospective interview-based study was conducted.
  • Thirty consecutive patients with aneurysmal SAH, 20 with ischemic stroke, and 100 controls were interviewed using a standard pro forma.

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  • Data collected included history of sudden headaches, timing, and physician consultation.

    • Main Results:

    • A history of warning headaches was reported by 43% of SAH patients, significantly more than in ischemic stroke patients (5%) or controls (0%).
    • The interval between a warning headache and SAH rupture ranged from one week to two months in most cases.
    • Only half of SAH patients with warning headaches consulted a physician; outcomes were slightly worse but not statistically significant.

    Conclusions:

    • Warning headaches are a frequent occurrence in patients with aneurysmal SAH.
    • Increased awareness and recognition of sudden headaches as potential SAH precursors are necessary.
    • Further strategies should be developed to improve the identification and management of patients experiencing warning headaches.