Background Headache accompanying ischemic stroke is considered an independent predictor of neurological deterioration. This meta-analysis aims to estimate the prevalence of ischemic stroke-related headaches and identify its risk factors in China. Methods PubMed, Embase, Cochrane Library database, Web of Science, PsycINFO, and four Chinese databases for the related publications were searched. Two researchers independently selected the literature, extracted the relevant data, and assessed its methodological quality. The meta-analysis applied a random-effects model with R software to calculate the pooled prevalence of ischemic stroke-related headaches in Chinese patients, and to merge the odds ratio (OR) of risk factors. Subgroup analysis, sensitivity analysis, and meta-regression analysis were conducted. Publication bias was assessed by a funnel plot and Egger test. Results Ninety-eight studies were eligible for inclusion. The overall pooled prevalence of ischemic stroke-related headache was 18.9%. Subgroup analysis showed that the prevalence of ischemic stroke related-headaches was higher among studies using self-report to diagnosis headache (18.9%; 95%CI, 8.9% to 40.2%), and those focused on age ≥ 55 years (19.7%; 95%CI, 14.9% to 25.9%), rural settings (24.9%; 95%CI, 19.7% to 31.6%). There were no significant differences in the headache prevalence between studies in the south and north, and inland and coastal studies. The prevalence of pre onset headache (13.9%) and tension-type headache (15.5%) and was higher compared with other types. History of headache (OR = 3.24; 95%CI, 2.26 to 4.65.), female gender (OR = 2.06; 95%CI, 1.44 to 2.96.), midbrain lesions (OR = 3.56; 95%CI, 1.86 to 6.83.), and posterior circulation stroke (OR = 2.13; 95%CI, 1.14 to 4.32) were major risk factors. Conclusion The prevalence of ischemic stroke-associated headache is high in China. In addition, women, presence of midbrain lesions, posterior circulation stroke and a history of migraine were high-risk factors for ischemic stroke-related headaches. Designing effective interventions to prevent or alleviated headaches is necessary to promote patients’ neurological recovery and quality of life.

Background: Stroke is characterized by high morbidity, high mortality, high disability rate, high recurrence rate and heavy economic burden. Post-stroke dysphagia (PSD) is one of the common complications of stroke, which can easily lead to adverse consequences such as repeated aspiration, malnutrition, pulmonary infection, and even asphyxia, and seriously affect the quality of life and prognosis of patients. For PSD patients, scientific and practical early rehabilitation measures can better improve the swallowing function, but the best time for early rehabilitation of PSD patients has not been reported. Therefore, we report on a randomized controlled trial (RCT) in which patients were offered early rehabilitation training using rehabilitation exercises for dysphagia after stroke. This protocol was written according to the SPIRIT 2013 Statement.Methods: This is a multi-center and pragmatic RCT. On the basis of sample size calculation, 180 patients with acute ischemic stroke were randomly enrolled from 3 different hospitals and divided into 4 groups: 1 control group and 3 experimental groups. The control group only received clinical routine electrical stimulation treatment, and the experimental group added rehabilitation exercise on this basis. According to the different starting time of rehabilitation exercise training after the onset of stroke, they were divided into 0-3 days group, 4-7 days group and 8-14 days group. Rehabilitation exercise training lasts for 4 weeks, once in the morning and once in the afternoon, about 30 minutes each time. Primary outcomes were the degree of improvement in patient swallowing function and efficacy assessment. Secondary outcomes, including incidence of choking, pulmonary infection, quality of life, and training compliance rates, were assessed at baseline and 4 weeks after intervention initiation.Discussion: The purpose of this study was to investigate the improvement of swallowing function in PSD patients after early rehabilitation training at different time.Trial registration: chictr.org.c, ID: ChiCTR2000029149. Full Registration on 1 May 2021. https://www.chictr.org.cn/ ChiCTR2000029149.