Importance of the recognition of a warning leak as a sign of a ruptured intracranial aneurysm.
In the Danish Aneurysm Study 1076 patients (pts.) were admitted with an aneurysmal subarachnoid hemorrhage in the 5-year period 1978-83. A warning leak (WL), defined as a sudden episode of headache, vomiting, nuchal pain, dizziness or drowsiness, was identified in 166 pts. (15.4%). In 99 of these the episode was evaluated by a physician but misdiagnosed. A 2-year follow-up examination of the 99 pts. showed that 30 pts. had a normal mental outcome and 43 pts. were dead. If these patients were correctly diagnosed after the WL, when they were in Hunt grade 1-2, the outcome-figures would probably have been significantly better. A theoretical transfer of the outcome-probabilities for pts. in Hunt grade 1-2 to the above mentioned 99 pts. would result in 66 pts. with a normal mental outcome and 25 dead pts. This shows the importance of recognition of a WL episode.
Hauerberg
J
J
Clinic of Neurosurgery, Copenhagen County Hospital, Glostrup, Denmark.
Andersen
B B
BB
Eskesen
V
V
Rosenørn
J
J
Schmidt
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D012307:Risk Factors; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed