Headache Attributed to Acute Ischemic Stroke in Chinese Patients: A Single Center Study

Aims: In this pilot study we aimed to investigate prevalence, characteristics and possible mechanisms of headache in acute ischemic stroke from a Chinese tertiary hospital.

Methodology: Five hundred and fifteen patients with acute ischemic stroke from Chinese PLA General Hospital were retrospectively investigated. Headache prevalence, features and correlations with several clinical parameters (age, sex, vascular risk factors, atherosclerosis, artery stenosis, infarct locations, presumed etiology according to TOAST criteria) were analyzed.

Results: Of 515 participants, 36 (7%) experienced headache during the acute event. Younger age, non-atherosclerosis and occipital lobe infarct were more associated with headache occurrence (P<0.05). Headache occurred mostly within one day before (41.7%) or simultaneously (47.2%) with other ischemic symptoms in a stroke. Most patients had tension-like headache. There is no significant correlation of headache location with infarct location.

Conclusion: Our study indicated that non-atherosclerosis cerebrovascular diseases and cortical spreading depression caused by occipital infarction might play a role in stroke onset headache. Headache may be a warning sign of stroke onset since most headaches occurred shortly before or simultaneously with stroke. Headache information needs to be fully recorded in prospective stroke registry.