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Headache in acute ischaemic stroke: a lesion mapping study.

Christian L Seifert1, Etienne M Schönbach2, Stefano Magon3

  • 11 Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Germany c.seifert@lrz.tu-muenchen.de.

Brain : a Journal of Neurology
|November 26, 2015
PubMed
Summary

Headache after acute ischemic stroke is linked to brain lesions in the insula and somatosensory cortex. This suggests central pain processing may drive stroke-related headaches in some patients.

Keywords:
MRIheadacheischaemic strokelesion mapping

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Area of Science:

  • Neurology
  • Neuroimaging
  • Pain Medicine

Background:

  • Headache is a frequent symptom of acute ischemic stroke.
  • The neurological mechanisms underlying stroke-related headaches remain unclear.
  • Identifying specific brain regions involved is crucial for understanding and managing this symptom.

Purpose of the Study:

  • To pinpoint brain regions associated with headache development in acute ischemic stroke patients.
  • To investigate potential lesional patterns correlating with headache in stroke survivors.

Main Methods:

  • A lesion mapping study involving 100 acute ischemic stroke patients (50 with headache, 50 without).
  • Brain Magnetic Resonance Imaging (MRI) at 3 Tesla with diffusion-weighted imaging.
  • Voxel-wise analysis of infarcts, including non-linear warping to standard stereotactic space and flipped analyses.

Main Results:

  • No significant differences were found in infarct volume, vascular distribution, or clinical stroke severity between groups.
  • Infarctions in headache sufferers were more frequently located in the insula and somatosensory cortex.
  • Insular strokes showed a strong association with headache development, confirmed by statistical testing (P < 0.01).

Conclusions:

  • Acute ischemic stroke-related headache may be centrally driven in a subset of patients.
  • The insula and somatosensory cortex are key brain regions implicated in stroke-related headache.
  • This study provides novel insights into the neuroanatomical correlates of headache following ischemic stroke.