eISSN: 1509-572x
ISSN: 1641-4640
Folia Neuropathologica
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2/2022
vol. 60
 
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abstract:
Original paper

Relation of post-stroke headachto cerebrovascular pathology and hemodynamics

Elsayed Abed
1
,
Nabil Hussein Mohammed
1
,
Ahmed Hassan Elsheshiny
1
,
Sandra Ahmed
2
,
Mohamed Hamed Rashad
1

1.
Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
2.
Department of Neurology, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
Folia Neuropathol 2022; 60 (2): 221-227
Online publish date: 2022/06/30
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Despite high prevalence of cerebrovascular stroke, headache attributed to ischemic strokes is often undertreated and overlooked. The aim is to detect the relation of a post-stroke headache to cerebrovascular pathology and changes in hemodynamics through a high-resolution duplex ultrasound examination. The present study was a case-control study conducted among 239 patients, who presented with an acute ischemic stroke. Patients were sub-divided into two groups: group I included patients with headache attributed to ischemic stroke (cases) and group II included headache-free stroke patients (controls). History consisted of headache characteristics and risk factors. Clinical and radiological examination were preformed to detect the type of stroke. Ultrasound duplex examination of extra-cranial and intra-cranial cerebrovascular system was carried for both groups. Group I included 112 patients (mean age, 57.66 ±6.59 years), and group II included 127 patients (mean age 57.73 ±7.89 years). Post-stroke headache was more frequent in patients with posterior circulation infarction (58%). Post-stroke headache was reported within 7 days post-stroke in 61.6% of patients. Pre-stroke headache was an independent predictor for post-stroke headache occurrence (OR = 28.187, 95% CI: 6.612-120.158%, p < 0.001). Collateral opening and various degrees of intra-cranial vascular stenosis were strong predictors of headache occurrence (OR = 25.071, 95% CI: 6.498-96.722%, p < 0.001). In conclusion, post-stroke headache is a common phenomenon, especially in patients with pre-stroke headache, history of old stroke, posterior circulation infarction, and large artery disease. This headache was of moderate-intensity with clinical characteristics of tension-type. Intra-cranial cerebrovascular pathological changes including opening of collateral channels and variable degrees of stenosis of cerebrovascular systems were implicated in the production of that headache.
keywords:

post-stroke headache, cerebrovascular, hemodynamics, duplex ultrasound

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