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Headache in intracerebral hematomas

T P Melo1, A N Pinto, J M Ferro

  • 1Department of Neurology, Hospital de Santa Maria, Faculdade de Medicina de Lisboa, Portugal.

Neurology
|August 1, 1996
PubMed
Summary
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Headache is common in patients with intracerebral hematoma (ICH), especially in cerebellar or lobar locations. Predictors include meningeal signs, herniation, and female gender, not just hematoma volume.

Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Headache is more frequent in intracerebral hemorrhage (ICH) than ischemic stroke.
  • Headache frequency in ICH correlates with hematoma location.
  • Pathophysiology of ICH-related headache remains unclear.

Purpose of the Study:

  • To determine the frequency and location of headache in intracerebral hematoma (ICH).
  • To identify clinical and CT predictors of headache in ICH using multivariate analysis.

Main Methods:

  • A cohort of 289 patients with ICH was studied over 14 months.
  • Clinical data, including headache presence and location, were collected.
  • CT scan features were analyzed by neurologists.

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Main Results:

  • 57% of ICH patients experienced headache at stroke onset.
  • Headache was more prevalent in cerebellar/lobar hemorrhages versus deep ones.
  • Significant predictors included meningeal signs, cerebellar/lobar location, transtentorial herniation, and female gender.

Conclusions:

  • Hematoma location, meningeal signs, and gender are stronger headache predictors than volume.
  • Headache in ICH may relate more to anatomical pathways and subarachnoid bleeding than intracranial hypertension.