Acute headache in general neurology of China: Cause changes and predictors of short-term outcome

Guangsheng Wang, Yeting Zhou, Xiaodong Chen, Hongjian Wang, Tonghui Yang, Chunhong Chang, Yuanwei Wang, Hanpei Gu, Daoming Tong

Department of Medical Affairs, Shuyang People’s Hospital, Shuyang, China.
Departments of Neurology, Shuyang People’s Hospital, Shuyang, China.
Medical Evaluation Unit, Shuyang People’s Hospital, Shuyang, China.

DOI: 10.4236/wjns.2012.22014                

Abstract

Background: Although patients with acute headache frequently present in emergency department, the causes and predictors of short-term outcome in patients with acute headache in general neurology have not been adequately investigated. Methods: We prospectively reviewed the medical records of 130 hospitalized acute headache pa-tients in general neurology of China. Their initial CT scan was assessed, as was their lumbar puncture (LP) examination if performed. Results: The main cause of acute headache was acute secondary headache (80.8%), which was mainly attributable to acute cerebrovascular events (72.4%) followed by intracranial infection (19.0%). Among the 10.8% of patients who died during hospitalization most (85.7%) had subarachnoid hemorrhage (SAH). Significant predictors of survival were severe headache versus thunderclap headache, meningismus, de-layed loss of consciousness, and hypertension (all p < 0.05). Multiple logistic regression analyses showed significant differences in severe headache or thunderclap headache (OR, 0.255; 95%CI, 0.066 - 0.990; p = 0.048) and delayed loss of consciousness (OR, 0.060; 95%CI, 0.016 - 0.224, p = 0.000) between patients who died and those who survived. Conclusions: The main underlying cause of hospitalized acute headache was acute cerebrovascular events. Severe headache and delayed loss of consciousness are predictors for poor outcome of acute headache.

Keywords

Acute Headache; Causes; Cerebrovescular Events; Subarachnoid Hemorrhage; Outcome

Conflicts of Interest

The authors declare no conflicts of interest.

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