Headache in stroke: the Copenhagen Stroke Study

Area of Science:

• Neurology
• Stroke Medicine
• Headache Research

Background:

• Uncertainty surrounds the incidence, pathophysiology, risk factors, and outcomes of stroke-related headaches.
• Previous research has not clearly defined the relationship between headache and stroke severity or prognosis.

Purpose of the Study:

• To investigate the incidence and independent risk factors of headache in acute stroke patients.
• To determine the association between stroke-related headache and stroke severity, lesion characteristics, and clinical outcomes.

Main Methods:

• A prospective, community-based study of 1,128 consecutive acute stroke patients was conducted.
• 867 patients (77%) were able to communicate and assess stroke severity using the Scandinavian Stroke Scale (SSS).
• Multivariate regression analyses were employed to identify independent risk factors and associations.

Main Results:

• Headache occurred in 28% of patients. Independent risk factors included older age, female sex, intracerebral hemorrhage, vertebrobasilar stroke, and ischemic heart disease.
• Headache lateralization was ipsilateral to the lesion in 68% of cases.
• No correlation was found between headache and initial stroke severity (SSS), lesion size, cortical involvement on CT, stroke outcome (SSS), or mortality.

Conclusions:

• Stroke-related headache is associated with demographic factors (age, sex) and stroke type (vertebrobasilar territory).
• Headache is not linked to stroke severity or cortical involvement in patients who can report reliably.
• Stroke-related headache does not appear to be related to stroke outcome or mortality.