A WARNING EAK: ACT FAST
There is one kind of headache you should never ignore. It is the headache that warns you a potentially disastrous incident is on its way. It’s an explosive headache that comes out of the blue and can be so severe that it feels like a slug on the head from a cricket bat. The ache can last from a few hours to a few days and often causes nausea.
If you heed it and seek medical attention, you will have a good chance of preventing a major insult to your brain. If you ignore it and suffer the insult, you are likely to be left disabled or dead.
People who have experienced such an event describe it as a headache unlike any they have ever had. Compared to other headaches, which tend to build up slowly, this one comes on at full power. It can be so forceful that it can knock you unconscious. A stressed executive can be working away at his desk when suddenly he collapses and falls to the floor unconscious. Colleagues will immediately suspect a heart attack but minutes later he will wake with the most intense headache imaginable. He may also be vomiting.
These headaches are caused by a small leak from a blood vessel in the head. The leak is into the subarachnoid space, which is between the membranes that separate the skull from the brain. This leak signals that a major blow-out in the vessel will soon follow. When the blow-out occurs, there will be a mighty haemorrhage, which, in 40 per cent of cases, will be fatal.
The warning leak is usually small and does not last long. After 1 or 2 days or so, the person begins to feel better and shrugs off the event. In a few cases, the leak also causes palsy in one eye. The eyelid won’t open of its own accord but when forced reveals a dilated pupil in an eye that only tracks outwards.
Half the men who suffer such a major haemorrhage have had a warning headache. After suffering a leak, many stay home from work and wait for the headache to subside. They never report it and days, or maybe weeks, later experience the blow-out. Only 20 per cent of them will ever fully recover. The tragedy is that if their leak had been detected, rapid surgery could almost certainly have prevented the blow-out.
The leak comes from a bulge in an artery, called an aneurysm. This bulge can vary in size. While most are as small as a cherry, there have been giant ones the size of hens’ eggs. Once this bulge is detected, surgeons can clip it off and prevent its bursting. This procedure takes about 3 hours, and the man can usually go home after a week.
While at least 2000 Australians are known to suffer this kind of haemorrhage every year, the figures could be higher. A sudden death in a middle-aged man, for example, might be automatically attributed to a heart attack. The examining doctor will assume a heart attack and decide no post mortem is necessary. But the sudden collapse may have been caused by a burst cerebral aneurysm.
People aged between 40 and 60 are most at risk of this condition, and the risk rises if there is a family history of the condition. First-degree relatives of people who have had a cerebral aneurysm are possibly more likely to have one than the general population. This risk increases to 10 per cent if two family members are known to have had one. Some diseases, such as polycystic kidney disease and fibromuscular dysplasia, also increase risk.
Research is under way to find methods of screening for these cerebral aneurysms. The goal is to recognise which patients are harbouring an aneurysm before they go on to have a haemorrhage. If a bulge in an artery is ready to leak or rupture, a sudden rise in blood pressure can trigger it. This rise may be caused by mental stress, or by physical exertion such as a jog or a game of squash.
*58\105\2*
Leave a Reply
You must be logged in to post a comment.