Systemic disease in practice: Aneurysms, subarachnoid haemorrhage and headaches

In our everyday practice we regularly meet patients who complain of headaches. Careful assessment is always important and, very occasionally, the decisions we make can have far reaching consequences for the patient’s health. Fortunately, most of the patients that experience the most severe forms of headaches usually present immediately to hospital and receive prompt treatment.

A 47-year-old male patient (SB), first started suffering ‘terrible’ headaches at the end of March 2011. He saw his general practitioner who diagnosed ‘migraine’. A week later the patient also started experiencing numbness on the left side and what he described as ‘strange visual sensations’ along with the headache. He was referred to a consultant neurologist who undertook an MRI scan. The scan revealed an aneurysm which had leaked slightly (Figure 1).