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A multivariate study of headache associated with ischemic stroke

J M Ferro1, T P Melo, V Oliveira

  • 1Servico de Neurologia, Hospital de Santa Maria, Faculdade de Medicina de Lisboa, Portugal.

Headache
|June 1, 1995
PubMed
Summary

Headache is a common symptom following ischemic stroke, particularly in younger patients and those with specific stroke locations like the vertebrobasilar system. Migraine history also increases the likelihood of stroke-associated headache.

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Area of Science:

  • Neurology
  • Stroke Medicine
  • Neuroscience

Background:

  • Headache is a frequent complaint among ischemic stroke patients.
  • Understanding the predictors of stroke-associated headache is crucial for diagnosis and patient care.

Purpose of the Study:

  • To investigate the incidence and clinical correlates of headache in patients with ischemic stroke.
  • To identify independent predictors of headache in ischemic stroke.

Main Methods:

  • Prospective registration of 182 ischemic stroke patients over 1 year.
  • Analysis of headache occurrence within 72 hours of stroke onset.
  • Multiple regression analysis to determine significant predictors.

Main Results:

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  • 34% of patients reported headache within 72 hours of ischemic stroke.
  • Headache was more common in younger patients, nonsmokers, those with a migraine history, and those experiencing transient loss of consciousness, nausea/vomiting, or visual defects.
  • Vertebrobasilar territory strokes (57%) had higher headache frequency than carotid territory strokes (20%), with posterior cerebral artery (90%) and cerebellar infarcts (80%) being particularly associated with headache.

    • Conclusions:

    • Ischemic stroke location is a major determinant of headache, with vertebrobasilar strokes showing a significantly higher incidence.
    • A history of migraine is a strong independent predictor of headache in ischemic stroke patients.
    • The trigeminovascular system activation, potentially modified by individual susceptibility, is implicated in stroke-associated headache.