What are the symptoms of a sentinel headache?

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Last updated: February 16, 2025 • View editorial policy

Differential Diagnosis for Warning Leak Headache Symptoms

  • Single most likely diagnosis + Subarachnoid hemorrhage (SAH) due to aneurysmal rupture: This is the most likely diagnosis because a "warning leak" headache is a classic symptom of a small, initial bleed from an aneurysm, which can precede a larger, more catastrophic rupture.
  • Other Likely diagnoses + Migraine headache: Migraines can cause severe, sudden-onset headaches that may be mistaken for a warning leak. + Thunderclap headache: This is a severe, sudden-onset headache that can be caused by various conditions, including reversible cerebral vasoconstriction syndrome (RCVS) or cervical artery dissection. + Tension headache: Although less likely, a severe tension headache could potentially be mistaken for a warning leak headache.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.) + Aneurysmal rupture: As mentioned earlier, a warning leak headache can precede a larger aneurysmal rupture, which is a medical emergency. + Arteriovenous malformation (AVM) rupture: Although less common, an AVM rupture can cause a warning leak headache and is a potentially life-threatening condition. + Cervical artery dissection: Dissection of the cervical arteries can cause a warning leak headache and is a medical emergency that requires prompt treatment.
  • Rare diagnoses + Pituitary apoplexy: This is a rare condition where a pituitary tumor undergoes sudden hemorrhage or infarction, causing a severe headache. + Colloid cyst rupture: A colloid cyst is a rare type of brain tumor that can rupture and cause a sudden, severe headache. + Spontaneous intracranial hypotension: This is a rare condition where there is a spontaneous leak of cerebrospinal fluid, causing a severe headache.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.