|کد مقاله||کد نشریه||سال انتشار||مقاله انگلیسی||ترجمه فارسی||نسخه تمام متن|
|5502737||1535083||2017||3 صفحه PDF||سفارش دهید||دانلود کنید|
- In patients with spontaneous subarachnoid hemorrhage treated with analgesics, headache duration can be very short
- In neurologically intact patients with SAH, headache disappeared in âÂ 5% <Â 24Â h after ictus and in âÂ 10% at 48Â h
- Earliest notification of absence of headache was 10 hours after ictus.
BackgroundIf acute severe headache disappears early after its onset, the question arises whether subarachnoid hemorrhage (SAH) should still be ruled out. We studied the initial time-course and minimal duration of headache in a consecutive series of neurologically intact patients with spontaneous SAH.MethodsWe included patients admitted between 2012 and 2015 within 48Â h after spontaneous SAH with a normal level of consciousness and no focal deficits. We retrieved data on headache severity, measured with a Numeric Rating Scale (NRS), <Â 48Â h after ictus. We analyzed the proportion of patients with a first NRS 0 and NRS <Â 3 within 48Â h after ictus and minimal headache duration. Patients were censored in case of a decrease in level of consciousness, aneurysm treatment, or early discharge.ResultsWe included 106 patients (62 aneurysmal SAH, 33 perimesencephalic hemorrhage, 11 other spontaneous SAH). All patients were treated with analgesics. Within 48Â h after ictus, a first NRS 0 was reported by 9 patients (8%;95%CI:3%-14%) and a first NRS <Â 3 by 22 patients (21%;95%CI:13%-28%). Shortest time lapse until NRS 0 was 10Â h in a patient with aneurysmal SAH who had been on acetaminophen and tramadol since 2:35Â h after ictus.ConclusionsIn a cohort of SAH patients with a normal level of consciousness and no focal deficits who all used analgetics, headache disappeared in around 10% within 48Â h after ictus. Our data indicate that a diagnostic work-up for SAH is also needed in patients using analgesics in whom headache has disappeared after 10Â h.
Journal: Journal of the Neurological Sciences - Volume 379, 15 August 2017, Pages 55-57