The clinical features of headache with subarachnoid hemorrhage (SAH) are distinct from those associated with other headache syndromes, according to the first study of its type that examined in detail the clinical characteristics of the presenting headache in SAH. Researchers enrolled patients through the emergency department and from the neurosciences intensive care unit, and documented clinical features of the headache including the time to peak intensity, location, associated symptoms, and activities that caused worsening. 158 subjects were enrolled, of whom 20 patients had SAH and 138 did not. They found:
- Notable distinguishing features on history included occipital location (55% in the SAH group vs 22% in the non-SAH group), “stabbing” quality (35% in the SAH group vs 5% in the non-SAH group), presence of prior headache (50% in the SAH group vs 83% in the non-SAH group), and associated meningismus (80% in the SAH group and 42% in the non-SAH group).
- 65% of patients with SAH reported that their headache peaked within 1 second of onset, compared with only 10% of those without SAH.
Mac Grory B, Vu L, Cutting S, Marcolini E, Gottshalk C, Greer D. Distinguishing characteristics of headache in nontraumatic subarachnoid hemorrhage. [Published online ahead of print November 4, 2017]. Headache. doi:10.1111/head.13218.
This Week's Must Reads
AD, Rest-Activity Rhythm Fragmentation Linked , JAMA Neurology; ePub 2018 Jan 29; Musiek, et al
Psychiatric Disease, Lower Rates of IVT Linked, Stroke; ePub 2018 Jan 26; Bongiorno, et al
Stroke Care Disparities in US Military Healthcare, J Neurolog Sci; ePub 2018 Jan 17; Blattner, et al
Setting Plays Role in Evaluating Cognitive Decline, Alzheimers Dement; ePub 2018 Jan 17; Snitz, et al
Incidence of Periictal Apnea in Epileptic Seizures, Epilepsia; ePub 2018 Jan 16; Lacuey, Zonjy, et al
Must Reads in Headache & Migraine
Prevalence of Optic Nerve Head Edema in the ED, Neurology; ePub 2018 Jan 5; Sachdeva, et al
Association Between Migraine and Suicidal Behavior, Headache; ePub 2017 Nov 29; Friedman, Zhong, et al
Features of SAH Headache Are Distinct from Others, Headache; ePub 2017 Nov 4; Mac Grory, et al
Complementary/Alternative Drug Use for Headache, Headache; ePub 2017 Jul 25; Zhang, et al
Headache in Idiopathic Intracranial Hypertension, Headache; ePub 2017 Jul 28; Friedman, Quiros, et al