Health

What are potential causes for a delayed headache in a patient with subarachnoid hemorrhage? The most important causes to rule out for a patient with a delayed headache following subarachnoid hemorrhage are hydrocephalus and aneurysm re-rupture. If these causes have been excluded, the later phases of headache are more likely due to vasospasm and aseptic …

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What is the pathophysiologic cause of a headache from subarachnoid hemorrhage? The pain caused by aneurysmal rupture may be related to stretching of the blood vessel wall. Another theory is that there is a temporary rise in intracranial pressure to equal the mean arterial pressure in order to abate the bleeding from the aneurysm. Other …

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What are the criteria from the International Headache Society for subarachnoid hemorrhage? 1. Severe headache of sudden onset fulfilling criteria C and D 2. Neuroimaging (CT or MRI T2 or flair sequences) or cerebrospinal fluid evidence of nontraumatic subarachnoid hemorrhage with or without other clinical signs 3. Headache develops simultaneously with hemorrhage 4. Headache resolves within 1 month

How is the diagnosis of subarachnoid hemorrhage made? If the patient presents within 6 hours of headache onset, the sensitivity of a noncontrast computed tomography (CT) is 100%. The sensitivity decreases to 93% within 24 hours of onset and 80% at 3 days. A lumbar puncture may be required to demonstrate the presence of blood, …

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What are possible physical examination findings in a patient with subarachnoid hemorrhage? Patients presenting with subarachnoid hemorrhage typically do not demonstrate any localizing signs. They may be lethargic or have meningismus. The exception is in cases of ruptured posterior communicating artery aneurysms. The posterior communicating artery is in close proximity to the third cranial nerve, …

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What is the most common cause of spontaneous subarachnoid hemorrhage? Saccular aneurysm rupture is the cause in 85% of spontaneous cases. Other causes of subarachnoid hemorrhage include arteriovenous malformation (AVM) rupture, vasculitis, trauma, or dissection. In approximately 10% of cases of spontaneous subarachnoid hemorrhage, no aneurysm or AVM is found and the diagnosis of perimesencephalic …

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How is the headache of subarachnoid hemorrhage often described? Headache following subarachnoid hemorrhage is often described by patients as “the worst headache of my life” or as a “thunderclap headache.” A thunderclap headache has been described as an acute, severe, and explosive headache that immediately reaches maximal intensity. The term “thunderclap headache” originates from 1986 …

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