Thunderclap headache: is it migraine?
In a prospective study, 14 out of 49 patients presenting to a Regional Neurosurgical Unit with sudden headache suggestive of subarachnoid haemorrhage had normal CSF and a normal CT scan: it did not prove possible, on clinical grounds alone, to distinguish these from those that had bled. We have now followed all these patients for a minimum of 18 months. Only one has had no further headache, 4 have had musculoskeletal pain, 5 psychogenic pain, and 4 migraine type symptoms. None went on to have an unequivocal subarachnoid haemorrhage, and we conclude that angiography cannot be justified in patients with this type of "thunderclap headache".
Harling
D W
DW
Department of Neurology, Pinderfields General Hospital, Wakefield, Yorkshire, UK.
Peatfield
R C
RC
Van Hille
P T
PT
Abbott
R J
RJ
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008297:Male; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000175:diagnosis