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Dennis E. Wilkins, MD; Harold B. Goldman, MD
Department of Neurology 2 Fenway Plaza, Fourth Floor Boston, MA 02215

Arch Neurol. 1994;51(5):447-448.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The Clinical Spectrum of Unruptured Intracranial Aneurysms" by Raps et al¹ was disturbing in its promulgation of headache as a presentation of unruptured aneurysms. Headaches that signal underlying unruptured aneurysms were variously described as "noncatastrophic recurring headaches" to an individual "cataclysmic headache"; lasting from "several years" to as short as a "thunderclap"; and distributed unilaterally or bilaterally, periorbitally or not, focally or diffusely. Of what discriminating value are these descriptors to those of us on the frontlines of headache care? Virtually, every headache patient would be included!

Additional mention was made of "noncatastrophic headaches distinct in quality from any previous pattern of headache" as a noteworthy marker for unruptured aneurysms. This statement is unfounded and would require a prospective study among unselected patients with headache for validation, especially since experience in a general neurology clinic does not obviously support such a contention. Also frequently stressed were "catastrophic" or "thunderclap" . . . [Full Text PDF of this Article]

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