What are the common symptoms of aSAH?
The hallmark of aSAH in a patient who is awake is the complaint of the worst headache of their life, which is described by 80% of patients who can give a history. This headache is characterized as being extremely sudden and immediately reaching maximal intensity (thunderclap headache). A warning or sentinel headache that precedes the aSAH-associated ictus is also reported by 10% to 43% of patients. Other common symptoms of aSAH include nausea and/or vomiting, stiff neck, photophobia, brief loss of consciousness, or focal neurological deficits (including cranial nerve palsies). In a retrospective study of 109 patients with proven aSAH, headache was present in 74%, nausea or vomiting in 77%, loss of consciousness in 53%, and nuchal rigidity in 35%. As many as 12% of patients die before receiving medical attention.