Importance of recognizing sentinel headache.
BACKGROUND
Sentinel headache (SH) is a kind of secondary headache and is characterized as sudden, intense, and persistent, preceding spontaneous subarachnoid hemorrhage (SAH) by days or weeks.


METHODS
Eighty-nine consecutive patients with a diagnosis of spontaneous SAH were evaluated following admission to the Neurosurgical Service at Santa Casa Hospital, Belo Horizonte, between December 2009 and December 2010.


RESULTS
Out of the 89 patients, 64 (71.9%) were women. Mean age was 48.9 years (SD ± 13.4, ranging from 18 to 85 years). Twenty-four patients (27.0%) presented SH, which occurred, in average, 10.6 days (SD ± 13.5) before a SAH. No statistically significant differences were observed between the presence of SH and gender, arterial hypertension and migraine (P > 0.05), Glasgow Comma Scale (GCS) and World Federation of Neurological Surgeons (WFNS) scale at admission.


CONCLUSIONS
The prevalence of SH was 27% in this study but no related factors were identified. Therefore, further clarification of this important entity is required so as to facilitate its recognition in emergency services and improve the prognosis of patients with cerebral aneurysms.
Neurology and Neurosurgery Service, Santa Casa Hospital, Belo Horizonte, Minas Gerais, Brazil.
Júlio Leonardo Barbosa
JL
Pereira
Lucas Alverne Freitas
LA
de Albuquerque
Marcos
M
Dellaretti
Gervásio Teles Cardoso
GT
de Carvalho
Gerival
G
Vieira
Marcella Israel
MI
Rocha
Laize Luzia Andrade
LL
Loures
Paulo Pereira
PP
Christo
Atos Alves
AA
de Sousa
Intracranial aneurysm; sentinel headache; subarachnoid hemorrhage