Wijdicks E F, Kerkhoff H, van Gijn J
University Department of Neurology, Utrecht, The Netherlands.
Lancet. 1988 Jul 9;2(8602):68-70. doi: 10.1016/s0140-6736(88)90004-9.
Seventy-one patients with sudden, severe, and unusual headache, but with normal computerised tomographic scan and cerebrospinal fluid, were followed for an average of 3.3 years. Twelve patients (17%) had identical recurrences, but again without evidence of subarachnoid haemorrhage. Findings on cerebral angiography, performed in four patients after the first attack and in two patients after recurrent episodes, were normal. Thirty-one (44%) of the seventy-one patients subsequently had regular episodes of tension headache or common migraine. If the computerised tomographic scan and cerebrospinal fluid findings are normal, this type of headache can be regarded as a benign symptom, and cerebral angiography is not indicated.
71例突发剧烈且异常头痛但计算机断层扫描和脑脊液检查正常的患者，平均随访3.3年。12例患者（17%）出现了相同症状复发，同样未发现蛛网膜下腔出血的证据。4例患者在首次发作后以及2例患者在复发后进行了脑血管造影，结果均正常。71例患者中有31例（44%）随后出现了紧张性头痛或普通偏头痛的规律性发作。如果计算机断层扫描和脑脊液检查结果正常，这种类型的头痛可被视为良性症状，无需进行脑血管造影检查。
