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Headache in acute stroke. A prospective study in the first 8 days
A Verdelho1, J M Ferro, T Melo
1Department of Neurosciences, Santa Maria Hospital, University of Lisbon, Lisbon, Portugal. averdelho@netcabo.pt
Cephalalgia : an International Journal of Headache
|February 5, 2008
Summary
Headaches are common in acute stroke patients, often presenting as continuous, bilateral pressure-type pain. Many stroke-related headaches may be a reactivation of prior primary headaches.
Area of Science:
- Neurology
- Neuroscience
- Clinical Medicine
Background:
- Headaches are a frequent symptom in patients experiencing acute stroke.
- Accurate classification of stroke-associated headaches is crucial for diagnosis and management.
- Existing classification systems may face challenges due to stroke-specific symptoms.
Purpose of the Study:
- To describe and classify headaches occurring in patients with acute stroke.
- To identify characteristics and patterns of stroke-related headaches.
- To evaluate the applicability of the International Classification of Headache Disorders criteria.
Main Methods:
- Consecutive patients admitted to a stroke unit were interviewed.
- A validated headache questionnaire was utilized.
- The International Classification of Headache Disorders (ICHD) criteria were applied for classification.
Main Results:
- Headache was reported by 124 patients (61% ischemic, 39% hemorrhagic stroke).
- Headaches typically began on the day of stroke, were continuous, pressure-type, bilateral, and anteriorly located.
- Tension-type headache was most frequent; 11% were unclassifiable by ICHD criteria, and up to 50% might represent reactivation of primary headaches.
Conclusions:
- Headaches associated with acute stroke have distinct characteristics.
- The International Classification of Headache Disorders criteria may require adaptation for stroke patients, especially considering symptoms like nausea/vomiting.
- Reactivation of previous primary headaches is a significant factor in stroke-associated headache presentation.
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