Warning Headache in Aneurysmal Subarachnoid Hemorrhage: A Case-Control Study

doi:10.1001/archneur.1988.00520330109018

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Vol. 45 No. 9, September 1988

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Warning Headache in Aneurysmal Subarachnoid Hemorrhage

A Case-Control Study

Robert D. Verweij, MD; Eelco F. M. Wijdicks, MD; Jan van Gijn, MD

Arch Neurol. 1988;45(9):1019-1020.

Abstract

• Thirty consecutive patients with aneurysmal subarachnoidhemorrhage (SAH), 20 patients with ischemic stroke, and 100controls were extensively interviewed about previous episodesof sudden headache, according to a standard pro forma. Thirteenpatients with SAH (43%) had a history of a forewarning headache,compared with only one of the patients with ischemic strokeand none of the controls. The interval from the warning headacheto the admission rupture was between one week and two monthsin all patients but one with SAH. Only half of the 13 patientswith a warning headache consulted their physician. The outcomewas slightly worse in patients with a warning headache, butthe differences did not reach statistical significance. Thesedata emphasize the frequent occurrence of warning headachesin SAH. Measures to increase the recognition of sudden headachesshould be considered.

Author Affiliations

From the University Department of Neurolgy, Utrecht, the Netherlands.

Footnotes

Accepted for publication Feb 15, 1988.

Reprint requests to University Hospital Utrecht, Nicolaas Beetsstraat24, 3511 HG Utrecht, the Netherlands (Dr Wijdicks).

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