Danbot: Complete article rewrite

2026-03-21T23:00:25Z

Complete article rewrite

← Older revision		Revision as of 23:00, 21 March 2026
Line 1:		Line 1:
	~~PMID~~ 9737490		{{JC info
			\| title= Headache Characteristics in Subarachnoid Haemorrhage and Benign Thunderclap Headache
			\| abbreviation=
			\| expansion=
			\| published= 1998
			\| author= Linn FH, Wijdicks EF, van der Graaf Y, Weerdesteyn-van Vliet FA, Bartelds AI, van Gijn J.
			\| journal= J Neurol Neurosurg Psychiatry
			\| year= 1998
			\| volume= 65
			\| issue= 5
			\| pages= 791-793
			\| pmid= 9737490
			\| fulltexturl=
			\| pdfurl=
			\| status = Complete
			}}

			==Clinical Question==
			Can "worst headache of life" or specific headache characteristics reliably distinguish subarachnoid hemorrhage from benign thunderclap headache?

			==Conclusion==
			*No single headache characteristic reliably distinguishes SAH from benign thunderclap headache
			*"Worst headache of life" alone has poor specificity for SAH
			*Further diagnostic workup (CT, LP) is required regardless of headache characteristics when SAH is suspected

			==Major Points==
			*The study compared headache features in patients with confirmed SAH vs benign thunderclap headache
			*Headache severity, onset pattern (sudden vs gradual), associated symptoms (nausea, vomiting, LOC) overlapped significantly between groups
			*Approximately 12% of patients presenting with "worst headache" had SAH
			*Neither the location nor the quality of headache was discriminating
			*The study reinforced the need for objective diagnostic testing (CT followed by LP if CT negative) rather than relying on headache phenomenology

			==Study Design==
			*Prospective cohort study
			*University Medical Center Utrecht, Netherlands
			*N = 148 patients with sudden severe headache
			*All patients underwent CT and lumbar puncture
			*Primary Outcome: headache characteristics that discriminate SAH from benign thunderclap headache

			==Population==
			===Inclusion Criteria===
			*Adults presenting with sudden onset severe headache (thunderclap headache)
			*Headache reaching maximal intensity within seconds to minutes
			===Exclusion Criteria===
			*Headache with obvious secondary cause other than SAH (e.g., meningitis, trauma)
			*Recurrent primary headache disorders with typical pattern

			==Interventions==
			*No therapeutic intervention; diagnostic accuracy study
			*All patients underwent standardized headache assessment, non-contrast CT head, and lumbar puncture
			*SAH was confirmed by CT findings or xanthochromia on CSF analysis

			==Outcomes==
			===Primary Outcome===
			*No headache characteristic was independently predictive of SAH vs benign thunderclap headache
			*Proportion with SAH: approximately 12% of patients with worst headache
			===Secondary Outcomes===
			*Overlap in headache features between SAH and benign thunderclap headache:
			**Sudden onset: present in both groups
			**Occipital location: similar frequency
			**Associated neck stiffness: more common in SAH but present in benign thunderclap
			**Vomiting: more common in SAH but not discriminating

			==Criticisms==
			*Relatively small sample size limits statistical power for subgroup analyses
			*Single-center study in a Dutch referral population
			*The definition of "thunderclap headache" may vary between practitioners
			*Selection bias: patients with milder headaches who may represent earlier SAH presentations may not have been included
			*The study did not evaluate modern risk stratification tools (e.g., Ottawa SAH Rule)

			==Funding==
			*Netherlands Heart Foundation

			==See Also==
			*[[Subarachnoid hemorrhage]]
			*[[Thunderclap headache]]
			*[[EBQ:Perry Subarachnoid Haemorrhage Study]]

			==References==
			<references/>

	[[Category:EBQ]]		[[Category:EBQ]]
			[[Category:Neurology]]

Rossdonaldson1 at 22:18, 1 December 2013

2013-12-01T22:18:26Z

← Older revision		Revision as of 22:18, 1 December 2013
Line 1:		Line 1:
	PMID 9737490		PMID 9737490

			[[Category:EBQ]]

Rossdonaldson1: Rossdonaldson1 moved page Worst headache and subarachnoid hemorrhage to EBQ:Worst headache and subarachnoid hemorrhage

2013-12-01T22:18:16Z

Rossdonaldson1 moved page Worst headache and subarachnoid hemorrhage to EBQ:Worst headache and subarachnoid hemorrhage

← Older revision	Revision as of 22:18, 1 December 2013
(No difference)

Ostermayer: Created page with "PMID 9737490"

2013-11-13T05:32:21Z

Created page with "PMID 9737490"

New page

PMID 9737490

EBQ:Worst headache and subarachnoid hemorrhage - Revision history

Danbot: Complete article rewrite

Rossdonaldson1 at 22:18, 1 December 2013

Rossdonaldson1: Rossdonaldson1 moved page Worst headache and subarachnoid hemorrhage to EBQ:Worst headache and subarachnoid hemorrhage

Ostermayer: Created page with "PMID 9737490"