Headache Characteristics in Acute Cerebral Blood Flow Disorders with Good Prognosis

Abstract

The diagnostic difficulties in patients suffering from headache as an only symptom of cerebrovascular disease with good prognosis are significant. The responses of 204 patients with severe headache to leading standard questions were prospectively studied. Subarachnoid hemorrhage (SH) with proven aneurysm was observed in 84 patients, brainstem hemorrhage (BH) - in 46 cases, and migraine - in 74 cases. Headache came on suddenly in 50 per cent of the patients with SH, in 35 per cent of the patients with BH and in 68 per cent of the patients with migraine. In the rest cases headache onset lasted for over one minute. Quantitative consciousness disturbances were found out in 26 per cent of the cases with SH, in 4 per cent of these with BH and in 16 per cent of these with migraine. Focal neurological symptoms were observed in 33,9 , and 22 per cent of the cases, respectively. Seizures and diplopia were established in SH only. Vomiting and physical effort preceding were reported in 69 and 50 per cent of the patients with SH, in 83 and 39 per cent of these with BH, and in 43 and 22 per cent of these with migraine. Aneurysmal SH was diagnosed in female patients with acute headache, seizures, reduced consciousness level or focal neurological symptoms, vomiting and physical effort. An aneurysmal rupture occurred when headache started several minutes after accident's onset.