Headache After Stroke: An Update for the Clinician

Headache in the context of stroke is common and represents significant morbidity in the acute and outpatient settings. This article reviews recent research on the incidence, pathophysiology and management of headache secondary to ischemic and hemorrhagic stroke.

Multiple studies have attempted to characterize the incidence and risk factors of post-stroke headache. Some studies regarding proposed pathophysiology exist but no clear consensus has been reached. Management strategies are limited and are typically guided by harm reduction rather than efficacy. There are some studies indicating that procedural based therapies can be both safe and effective with multiple ongoing trials focusing on ganglion blocks. The use of calcitonin-gene related peptide based therapies are limited in this setting with no robust evidence to its safety or efficacy. Headache following ischemic stroke and hemorrhagic stroke is prevalent and likely impedes recovery and quality of life. Management options are limited, though studies show promising initial results and trials are ongoing.