Harling D W, Peatfield R C, Van Hille P T, Abbott R J
Department of Neurology, Pinderfields General Hospital, Wakefield, Yorkshire, UK.
Cephalalgia. 1989 Jun;9(2):87-90. doi: 10.1046/j.1468-2982.1989.0902087.x.
In a prospective study, 14 out of 49 patients presenting to a Regional Neurosurgical Unit with sudden headache suggestive of subarachnoid haemorrhage had normal CSF and a normal CT scan: it did not prove possible, on clinical grounds alone, to distinguish these from those that had bled. We have now followed all these patients for a minimum of 18 months. Only one has had no further headache, 4 have had musculoskeletal pain, 5 psychogenic pain, and 4 migraine type symptoms. None went on to have an unequivocal subarachnoid haemorrhage, and we conclude that angiography cannot be justified in patients with this type of "thunderclap headache".
在一项前瞻性研究中，49名因突发头痛提示蛛网膜下腔出血而就诊于某地区神经外科病房的患者中，有14名患者脑脊液检查正常且CT扫描正常：仅依据临床症状，无法将这些患者与真正出血的患者区分开来。我们现在对所有这些患者进行了至少18个月的随访。只有1名患者未再出现头痛，4名患者有肌肉骨骼疼痛，5名患者有精神性疼痛，4名患者有偏头痛样症状。没有患者随后明确发生蛛网膜下腔出血，我们得出结论，对于这类“霹雳样头痛”患者，血管造影检查并无必要。
