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Persistent headache attributed to past ischemic stroke: A prospective cohort study.

Felipe A A de Oliveira1,2, Mario G Dourado-Filho2, Pedro A Sampaio Rocha-Filho3,4

  • 1Postgraduate Program in Neuropsychiatry and Behavioral Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Brazil.

Headache
|January 19, 2024
PubMed
Summary

Persistent headache after ischemic stroke is common, affecting 10.1% of patients. Previous migraine and acute headache intensity are key risk factors for this debilitating post-stroke complication.

Keywords:
cerebrovascular diseaseheadacheheadache disordersischemic strokemigraine disorderspainsecondaryvascular headaches

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Area of Science:

  • Neurology
  • Stroke Medicine
  • Headache Disorders

Background:

  • Persistent headache post-ischemic stroke is recognized but under-researched.
  • Limited data exists on its incidence, characteristics, and risk factors.

Purpose of the Study:

  • To determine the incidence of persistent headache following ischemic stroke.
  • To characterize the features of this headache type.
  • To identify risk factors associated with its development.

Main Methods:

  • Prospective cohort study of 119 ischemic stroke patients.
  • Assessment included diffusion-weighted MRI, NIH Stroke Scale (NIHSS), and Headache Impact Test.
  • Patients were interviewed 1-year post-stroke via telephone.

Main Results:

  • 10.1% of patients developed persistent headache attributed to ischemic stroke.
  • Migraine-like pattern was most frequent (58.3%), with significant impact in 41.7%.
  • Previous migraine history (OR 7.1) and acute phase headache intensity (OR 1.75) were significant risk factors.

Conclusions:

  • Persistent headache is a frequent complication after ischemic stroke.
  • It significantly impacts patients' quality of life.
  • A migraine-like phenotype is common, with prior migraine and acute pain intensity as predictors.