Headache in Acute Cerebrovascular Disease: A Prospective Clinical Study in 240 Patients

Abstract

To evaluate the clinical features of headache in stroke, a prospective study was carried out in 240 consecutive patients with acute stroke who had intact expressive function. Headache occurred in 38%: 32% of 195 patients with ischemic stroke and 64.5% of 45 patients with hemorrhagic stroke (p < 0.0001). Headache patients were younger (mean age 62 +/- 15 vs 67 +/- 11.5 years) than non-headache patients (p < 0.01). A history of previous vascular or tension-type headache was found in 40.5% of the headache group, but in only 23.5% of the non-headache group (p < 0.01). In ischemic stroke, headache was observed in 41% of thrombotic infarcts, in 39% of cardioembolic infarcts, in 23% of lacunar infarcts and in 26% of TIA. Headache was significantly more common in thrombotic than lacunar infarcts (p < 0.05). In hemorrhagic stroke, headache was observed in all subarachnoid hemorrhages and in 58% of intraparenchymal hemorrhages. In ischemic stroke, the mean duration of the headache was 25 +/- 28 h and in hemorrhagic stroke 64.5 +/- 36.5 h (p < 0.00001). In ischemic stroke the headache was focal in 74% and mild or moderate in intensity in 74%. In hemorrhagic stroke, it was diffuse in 52% and the pain intensity was incapacitating in 70%. Headache was more common in vertebrobasilar stroke (59%), in comparison with carotid stroke (26%) or stroke of unclear vascular topography (33%) (p < 0.00001). Fifty-six and a half percent of patients with cortical stroke had headaches, as opposed to only 26.5% of patients with subcortical stroke (p < 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

Post-IV thrombolytic headache and hemorrhagic transformation risk in acute ischemic stroke

“…4,[8][9][10][11][12][13][14][15][16] In addition, we found that patients who developed headaches after tPA administration were younger, which is consistent with a previous observation. 17 One previous study reported a higher incidence of headache in cardioembolic infarcts than in TIAs, lacunar infarcts, or thrombotic infarcts.…”

Spontaneous Neurological Deterioration in Acute Cardioembolic Stroke: A Subgroup of Patients With Early Severe Prognosis

“…Moreover, severe headache was an early clinical marker signifi cantly associated with END in the logistic regression analysis (OR = 2.95). In a previous study by our group [28], the incidence of headache in cardioembolic stroke was 39% (severe-incapacitating 11% and mild-moderate intensity in 28%), which is similar to the frequency reported in other studies [29,30]. As far as we are aware, this is the fi rst study showing an association between severe headache at stroke onset and END in patients with cardioembolic infarction.…”

The Usefulness of Magnetic Resonance Imaging for Acute Isolated Vertigo Patients in the Emergency Department

“…Headache is observed in about 15% to 40% of patients with acute ischemic stroke and is seen more often in patients with posterior circulation stroke (59%) [23] compared with other areas [24] . In this study, we found that headache can be an important sign of central vertigo.…”