Arch Neurol Chicago
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Arch Neurol Chicago · Sep 1988
Warning headache in aneurysmal subarachnoid hemorrhage. A case-control study.
Thirty consecutive patients with aneurysmal subarachnoid hemorrhage (SAH), 20 patients with ischemic stroke, and 100 controls were extensively interviewed about previous episodes of sudden headache, according to a standard pro forma. Thirteen patients with SAH (43%) had a history of a forewarning headache, compared with only one of the patients with ischemic stroke and none of the controls. The interval from the warning headache to the admission rupture was between one week and two months in all patients but one with SAH. ⋯ The outcome was slightly worse in patients with a warning headache, but the differences did not reach statistical significance. These data emphasize the frequent occurrence of warning headaches in SAH. Measures to increase the recognition of sudden headaches should be considered.
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Two patients who were treated with lithium for psychiatric illness developed primary position downbeat nystagmus. Previous reports have suggested that lithium causes this type of nystagmus, but other known causes were present in most cases. ⋯ Lithium carbonate is a cause of primary position downbeat nystagmus. The nystagmus may be permanent or require several months of abstinence for improvement.