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The timing and nature of a headache can be a vital clue to intracranial bleeding.

Neurosurgeon Dr Moventhiran Ramakrishnan said in cases of hypertensive bleeds, the headache often appears suddenly - you could be having breakfast, feeling fine and within minutes be struck with a headache and weakness.

But with an aneurysm rupture, there’s a unique warning sign - a headache that appears one to two weeks before the major event, in someone who’s never had migraines before. This is called a sentinel hemorrhage - a small leak that irritates the brain, quietly sounding the alarm.

When the full rupture happens, it triggers what patients describe as a thunderclap headache - the worst headache they’ve ever experienced.

Watch now to understand the signs your brain may be sending.

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Transcript
00:00Dalam satu atau dua minggu sebelum keadaan yang terjadi, mereka akan mula mempunyai penyakit.
00:05Itu bermakna penyakit adalah sebuah-sebuah yang seperti, mengapa saya mempunyai penyakit?
00:09Sebab saya bukan orang migran, saya tidak mempunyai penyakit migran atau apa-apa.
00:15Jadi, apa yang terjadi? Kita panggilnya sentinel hemorrhage.
00:17Itu bermakna penyakit aneurysm akan mula-mula-mula berlalu-lalu.
00:21Jadi, apabila orang-orang, apabila mereka mempunyai penyakit,
00:24tetapi ini adalah sebuah-sebuah yang seperti, ini adalah sebuah-sebuah yang tidak hanya sebuah penyakit yang normal.
00:31Dan mereka tidak hanya boleh diberikan penyakit dari penyakit like that.
00:36In this kind of brain bleed, especially, in hypertension,
00:42penyakit is always in a very short term of period, short term of time,
00:46because they will associate with other symptoms as well, like weakness.
00:49So, sometimes, they don't tell they have a headache for one, two weeks or three weeks before of that.
00:55And so, it can happen like you wake up, you go for your breakfast,
00:59suddenly you are sitting down, you have a headache and you drop.
01:01Okay.
01:02That means it's very sudden.
01:04But in aneurysm ruptured, example, this is a very specific.
01:08So, this is a typical sign that always miss, actually.
01:11In a one or two weeks before the major incident to happen, they will start to have a headache.
01:16That means the headache is like, something is like, why I got a headache?
01:21Because I'm not a migraine person.
01:23I was not in a migraine medication or anything.
01:27So, what happened?
01:27We call it sentinel hemorrhage.
01:29That means the ruptured of aneurysm start to happen slowly, slowly.
01:33Irritates the brain and brain gives the symptoms.
01:35But on the day of the event, they will have that.
01:39They know this is my thunderclap headache.
01:43This is the bad headache that I never had before.
01:45Okay.
01:46You might be lucky if you can walk off, walk to our emergency department.
01:51But most of them will come in at a reduced conscience level.
01:54But when they wake up, when we ask them, they will tell that is that headache that I won't forget in my life.
02:01most of them will tell that there was more trouble.
02:06Terima kasih kerana menonton!
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