Sentinel Headache

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What is a sentinel headache

Sentinel headache is a sudden, severe headache occurring preceding major aneurysmal subarachnoid hemorrhage by days or weeks in 10% to 43% of cases.

The sentinel headache may be due to minor aneurysmal bleeding or expansion of the aneurysmal wall. Sentinel headache is not associated with neck stiffness, altered levels of consciousness, or focal neurologic signs. 

Many patients who do present with subarachnoid hemorrhage often describe a preceding “sentinel headache,” which has been found to occur in 10% to 40% of patients. The sentinel headache has been attributed to a possible small leak in the aneurysm or sudden enlargement of the aneurysm.


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