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New diagnostic criteria for headache attributed to transient ischemic attacks.
Elena R Lebedeva1,2,3, Natalia M Gurary4, Jes Olesen5
1Department of Neurology, the Ural State Medical University, Repina 3, Yekaterinburg, 620028, Russia. cosmos@k66.ru.
The Journal of Headache and Pain
|September 8, 2019
Summary
New criteria for diagnosing headache attributed to Transient Ischemic Attack (TIA) are proposed. Current International Classification of Headache Disorders criteria are insensitive; the new criteria show high sensitivity and specificity for TIA headaches.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Current diagnostic criteria for Headache Attributed to Transient Ischemic Attack (TIA) rely on expert opinion.
- The International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria for TIA headaches require field testing.
Purpose of the Study:
- To field test the ICHD-3 diagnostic criteria for headache attributed to TIA.
- To propose improved diagnostic criteria for headache attributed to TIA.
Main Methods:
- A cohort of 120 TIA patients and 192 controls were interviewed using validated semi-structured forms.
- Headache characteristics and TIA-related symptoms were recorded.
- Magnetic resonance imaging or computed tomography excluded infarction in TIA patients.
Main Results:
- Only 24% of TIA patients' headaches met ICHD-3 criteria.
- A new headache occurred within 24 hours in 13% of TIA patients versus 0% in controls.
- Proposed new criteria were met by 94% of TIA patients' headaches with excellent specificity.
Conclusions:
- The existing ICHD-3 diagnostic criteria for headache attributed to TIA are insufficiently sensitive.
- New diagnostic criteria offer high sensitivity and preserved specificity for TIA-related headaches.
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