LB Morgenstern, H Luna-Gonzales, JC Huber, Jr et al [ Univ of Texas, Houston]
Worst Headache and Subarachnoid Hemorrhage : Prospective, Modern Computed Tomography and Spinal Fluid Analysis
Ann Emerg Med 32; 297-304, 1998
The ability of modern head CT to exclude subarachnoid Hemorrhage [SAH] was investigated.
The authors conclude that patients reporting the “worst headaches of their lives” should undergo noncontrast head CT. If the CT result is negative, patients should undergo lumbar puncture. Undiagnosed SAH would have devastating consequences like acute rupture of an aneurysm or arteriovenous malformation. It is stressed that though lumbar puncture is painful and uncomfortable, it is diagnostically more informative than modern head CT.