Case Report: Subarachnoid Hemorrhage in Woman with Migraines

摘要

In a hospital-based series of 482 patients admitted with subarachnoid hemorrhage, initial misdiagnosis occurred in 12 percent of patients.1 Failure to obtain a head CT scan at initial contact was the most common error, occurring in 73 percent of misdiagnosed patients. Among patients with subarachnoid hemorrhage who had normal mental status at first contact (45 percent), the misdiagnosis rate rose to 20 percent; this was associated with a nearly fourfold increase in mortality at 12 months as well as increased morbidity among survivors.2 Sudden "thunderclap" (also known as sentinel) headache, regardless of severity or headache history, should raise the clinical suspicion for subarachnoid hemorrhage.