EXPLOSIVE HEADACHES MIMICKING SUBARACHNOID HEMORRHAGE

  • 1 January 1977
    • journal article
    • research article
    • Vol. 133  (2) , 131-138
Abstract
That migraine can present with a severe headache of sudden onset mimicking that of subarachnoid hemorrhage, the so-called complicated migraine with meningeal manifestations of Pearce and Foster, is not readily appreciated. Patients (7) were referred to us with a presumable diagnosis of subarachnoid hemorrhage. In each one of these patients, the clinical features (an explosive headache, relapsing in 3, and a normal neurological examination) together with appropriate laboratory investigations (CSF analysis, EEG, echoencephalography, brain scan, arteriography and pneumoencephalography) ruled out the diagnosis of subarachnoid hemorrhage, and less common causes of explosive headaches such as ball-valve tumors of the ventricular system, intra-cerebral hemorrhage and hemorrhage into a tumor. In 3 of these 7 patients, there was no history of migraine. Benign explosive headaches mimicking subarachnoid hemorrhage, occurring in patients with or without antecedents of migraine, are apparently not as unusual as one might conclude from a review of the literature. Proper recognition of this syndrome is important since it might help to sort out those patients with explosive headaches who need not be submitted indiscriminately to risk-fraught procedures.

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