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Headache in cerebrovascular disease.

R K Portenoy, C J Abissi, R B Lipton

    Stroke
    |November 1, 1984
    PubMed
    Summary

    Headache is common in cerebrovascular events, affecting over half of patients with parenchymal hemorrhage. Headache characteristics do not predict stroke type or location, but prior headache history and female sex increase likelihood.

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    Area of Science:

    • Neurology
    • Vascular Neurology

    Background:

    • Headache is a frequent symptom in patients experiencing cerebrovascular events.
    • Understanding the incidence and characteristics of headache associated with different types of cerebrovascular events is crucial for diagnosis and management.

    Purpose of the Study:

    • To prospectively evaluate the incidence and characteristics of headache in patients with cerebrovascular events.
    • To determine if headache occurrence or features can predict the type or location of the cerebrovascular lesion.

    Main Methods:

    • Prospective evaluation of 215 consecutive patients with cerebrovascular events.
    • Data collection on headache occurrence, quality, onset, and duration in 163 communicative patients.
    • Analysis of headache patterns in relation to stroke type (bland infarcts, parenchymal hemorrhage, transient ischemic attacks, lacunar infarcts).

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    Main Results:

    • Headache occurred in 29% with bland infarcts, 57% with parenchymal hemorrhage, 36% with transient ischemic attacks, and 17% with lacunar infarcts.
    • Patients with a history of throbbing headache were more likely to experience headache during the event, often throbbing in quality.
    • Women experienced headache more frequently than men; headache preceded the event in 60% of cases.

    Conclusions:

    • Headache is a common symptom in cerebrovascular disease but does not reliably predict lesion type or location.
    • The association with prior headache suggests shared underlying mechanisms.
    • Further research into the pathogenesis of headache in cerebrovascular events is warranted.