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Acute headache attributed to ischemic stroke: assessment of its characteristics and associated factors
Felipe Araújo Andrade de Oliveira1,2, Mário Genuíno Dourado-Filho2, Pedro Augusto Sampaio Rocha-Filho1
1Universidade Federal de Pernambuco, Área Acadêmica de Neuropsiquiatria do Centro de Ciências Médicas, Recife PE, Brazil.
Insights
Headache linked to ischemic stroke is common, affecting nearly 25% of patients. This stroke-related headache often resembles tension-type headaches and is more likely in those with a history of migraines or tension headaches.
Area of Science:
- Neurology
- Stroke Medicine
- Headache Disorders
Background:
- Headache is a frequent symptom in ischemic stroke, occurring in 7.4% to 34% of cases.
- Despite its prevalence, risk factors and characteristics of stroke-attributed headache remain understudied.
Purpose of the Study:
- To determine the frequency and clinical features of headache associated with ischemic stroke.
- To identify factors linked to the occurrence of stroke-related headache.
Main Methods:
- A cross-sectional study included 221 patients admitted within 72 hours of ischemic stroke onset.
- Data collected via semi-structured questionnaires and confirmed with magnetic resonance imaging.
Main Results:
- Headache attributed to ischemic stroke occurred in 24.9% of patients.
- Headache characteristics included a median duration of 21 hours, gradual onset, moderate intensity, pulsatile nature, and bilateral presentation, often resembling tension-type headaches.
- A history of tension-type headache and migraine (with or without aura) was significantly associated with headache attributed to stroke.
Conclusions:
- Headache is a common occurrence in ischemic stroke patients.
- The clinical presentation of stroke-related headache frequently mimics tension-type headaches.
- Previous history of tension-type or migraine headaches are significant risk factors for developing headache during ischemic stroke.
Background:
It is estimated that headache attributed to ischemic stroke occurs in 7.4% to 34% of the cases. Despite its frequency, this headache has been little studied in terms of its risk factors and characteristics.
Objective:
To assess the frequency and clinical characteristics of headache attributed to ischemic stroke and the factors associated with its occurrence.
Methods:
The present was a cross-sectional study which included patients consecutively admitted within 72 hours of the onset of ischemic stroke. A semi-structured questionnaire was used. The patients underwent magnetic resonance imaging.
Results:
A total of 221 patients were included, 68.2% of whom were male, and the mean age was of 68.2 ± 13.8 years. The frequency of headache attributed to ischemic stroke was of 24.9% (95% confidence interval [95%CI]: 19.6-31.1%). The headache had a median duration of 21 hours and most frequently began at the same time as the focal deficit (45.3%), with a gradual onset (83%). It was of moderate intensity, pulsatile (45.3%), bilateral (54.6%), and presented a similar pattern to that of tension-type headache (53.6%). Headache attributed to stroke was significantly associated with previous tension-type headache, and previous migraine with and without aura (logistic regression).
Conclusion:
Headache attributed to stroke is common, with a pattern similar to that of tension-type headache, and it is associated with a history of tension-type and migraine headaches.
