Elsayed Abed
Al-Azhar University, Egypt
Title: Relation of post-stroke headache to cerebrovascular pathology and hemodynamics
Biography
Biography: Elsayed Abed
Abstract
Background: Despite the 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.
Methods: This is a prospective case-control study that was conducted in Kasralainy hospital, Cairo University and Al-Azhar University hospitals from January 2021 to August 2021. The study was conducted on 239 patients who presented with an acute ischemic stroke. Patients were subdivided into two groups; Group I included patients with headache attributed to ischemic stroke (cases) and Group II included headache-free stroke patients (controls). History included headache characteristics and risk factors [Table 1]. Clinical and radiological examination was performed to detect the type of stroke. Ultrasound duplex examination of the extracranial and intracranial cerebrovascular system was carried for both groups.
Results: Group I included 112 patients (mean age 57.66 ± 6.59 years); 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 [Figure 1] and various degrees of intracranial vascular stenosis were strong predictors of headache occurrence (OR=25.071, 95% CI: 6.498-96.722, P<0.001).
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. The intracranial cerebrovascular pathological changes including opening of the collateral channels and variable degrees of stenosis of cerebrovascular systems were implicated in the production of that headache.