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Headache associated with ischemic stroke are prevalent in patients with migraine, larger ischemic lesions, vertebrobasilar strokes and ischemic stroke with cortical involvement.
The headache due to ischemic stroke is frequent and usually has a tension‐type headache pattern with a varying frequency as per a stroke’s etiology, as described in a narrative review published in 'Headache- The Journal of Head and Face Pain'.
Although the headaches attributed to ischemic strokes and transient ischemic attack arise frequently, they are often overlooked and underdiagnosed as indications of cerebrovascular disease. The occurrence of headache due to ischemic stroke differs between 7.4% - 34% of cases and headache due to transient ischemic attack, from 26% - 36%. Headache due to ischemic stroke is more commonly observed in younger patients, in migraineurs, those who have suffered a larger stroke, a posterior circulation infarction, or a cortical infarction, and is less common in lacunar infarctions. The most frequent pattern of headache attributed to ischemic stroke is a mild to moderate bilateral pain, not concerned with nausea, vomiting, photophobia, or phonophobia. This headache type mostly has a concomitant onset with a focal neurologic deficit and improves over time.
A few studies that have evaluated the value of headache for a prognosis of ischemic strokes have revealed conflicting results. No clinical trials on pain management or prophylactic treatment of persistent headache attributed to ischemic stroke have been devised. "Further studies are needed on pain management, prophylactic treatment, and characteristics of this headache", concluded the study authors.
Headache- The Journal of Head and Face Pain
Headaches Attributed to Ischemic Stroke and Transient Ischemic Attack
Felipe Araujo Andrade Oliveira et al.
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