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Hemostasis findings in headache and psychosocial stress associated with cerebral ischemia
1From the Department of Neurology, University of Southern California School of Medicine, Los Angeles, CA, U.S.A.
Insights
Headache and psychosocial stress are common in cerebral ischemia patients. Chronic stress does not appear to increase blood clotting, and headache in these patients is unlikely platelet-mediated.
Area of Science:
- Neurology
- Hematology
- Psychosomatic Medicine
Background:
- Cerebral ischemia is a significant health concern.
- The relationship between headache, psychosocial stress, and hemostatic function in cerebral ischemia patients requires further investigation.
Purpose of the Study:
- To assess the prevalence of headache and psychosocial stress in patients with cerebral ischemia.
- To evaluate the hemostatic function in these patients in relation to headache and stress levels.
Main Methods:
- Assessed headache and psychosocial stress using patient history and standardized questionnaires.
- Measured hematocrit, white blood cell count, fibrinogen, beta-thromboglobulin, and Fibrin D-dimer.
- Compared hemostatic markers between patients with and without headache, and between high- and low-stress groups.
Main Results:
- Headache and psychosocial stress were reported by one-third and one-half of eligible patients, respectively.
- No significant differences in hematocrit, white blood cell count, fibrinogen, or beta-thromboglobulin were found between groups.
- Fibrin D-dimer levels were significantly lower in high-stress patients compared to low-stress patients.
Conclusions:
- Headache associated with cerebral ischemia is unlikely to be platelet-mediated.
- Chronic psychosocial stress in this population does not appear to be associated with procoagulant tendencies.
Abstract:
We assessed the prevalence of headache and psychosocial stress in a group of patients with cerebral ischemia and evaluated hemostatic function in these patients. Headache and preceding psychosocial stress were present in one-third and one-half, respectively, of patients capable of providing an adequate history and answering a standardized psychosocial questionnaire. There were no significant differences in hematocrit, white blood cell count and differential, fibrinogen, and platelet activation peptide ß-thromboglobulin, between patients with and without headache and between high- and low-stress patients. Fibrin D-dimer (a fragment of cross-linked fibrin) was significantly lower in high-stress compared to low-stress patients. There was no association between headache and stress level. These findings make unlikely the hypothesis that headache associated with cerebral ischemia is platelet-mediated and suggest that psychosocial stress on a chronic basis is not associated with procoagulant tendencies in this population.
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