Headache at stroke onset: the Lausanne Stroke Registry

Area of Science:

• Neurology
• Stroke Medicine
• Pain Research

Background:

• Headache is a common symptom that can occur during a stroke.
• Understanding the relationship between headache and stroke is crucial for diagnosis and treatment.

Purpose of the Study:

• To investigate the prevalence and characteristics of headache in patients experiencing their first stroke.
• To explore the association between headache and different stroke types, locations, and underlying mechanisms.

Main Methods:

• A registry-based study of 2506 patients with first-ever stroke admitted to the Lausanne Stroke Registry within 12 hours of onset.
• Patients were questioned about the presence, topography, and characteristics of headache.

Main Results:

• Eighteen percent of stroke patients reported headache, with higher prevalence in posterior circulation stroke (29%) and hemorrhagic stroke (36%).
• Frontal headache was common in anterior circulation stroke, while diffuse or occipital headache was frequent in posterior circulation stroke.
• Stroke due to dissection was strongly associated with headache, whereas embolic stroke was more commonly associated with no headache.

Conclusions:

• Headache is a significant symptom in acute stroke, with varying prevalence and characteristics depending on the stroke subtype and location.
• The findings suggest that vascular mechanisms, including vessel distention and mechanical stimulation, play a role in stroke-related headache.
• The involvement of dual trigeminal-vascular and cervical-vascular systems may explain atypical headache presentations in some stroke cases.