EP 9. Prevalence, clinical characteristics and long-term course of headache in patients with stroke (multicenter study of DMKG). Issue 9 (September 2016)

• Record Type: Journal Article
• Authors: Dietrich, S.; Düring, A.; Rothkirch, D.; Filippopulos, F.; Eren, O.; Dresler, T.; Straube, A.; Goßrau, G.; Kraya, T.
• Is Part Of: Clinical neurophysiology. Volume 127:Issue 9(2016:Sep.)
• Page Start: e236
• Publication Date: 2016-09
• Subjects: Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2016.05.064
• Languages: English
• ISSNs: 1388-2457

Abstract

Abstract : Background: Headache in association with stroke is a symptom not at all differentiated and investigated in Germany. According to previous data, it seems to be a common problem, but usually other symptoms of stroke are predominating. Furthermore, the treatment is focused on acute therapy of ischemic stroke followed by rehabilitation. However, headaches in subarachnoid hemorrhage as a special type of stroke represents the leading clinical symptom and thus also be diagnostically significant. Headache in stroke should be classified as symptomatic headache (IHS 6.1–6.2). Methods: Affirmative vote of the ethics committees of all above named study centers. Patients were included within 24 h after onset of stroke symptoms and were interviewed for headache at the first to third Day by a self constructed questionnaire. The follow-up is also made by questionnaire which is completed by the patients themselves after 3, 6 and 12 months. Questionnaires from all the Study centers should be sent back to the Department of Neurology, University of Halle/Saale for central evaluation. Results: So far 244 patients were included from which 98 stroke patients complained for headache (40%) at least one of the first three days. This occurred in 45% of female and 36% of male patients. The most common diagnoses were Ischemic stroke with 65% (159/244) and TIA (transient ischemic attack) with 28% (67/244). Headache were complained by 37% (58/159) of the patients with ischemic stroke and 43% (29/67) with TIA. The headache frequency decreases during the first 3 days. After 3 months 201 patients were asked so far, 93 responses (47% return), 35% of them with persistent headache. After 6 months, 81 patients were asked till now, 42 responses (52% return), 27% with persistent headache. Discussion: Headache prevalence from day one to three was higher than in previous studies of Ischemic Stroke (27–31%, Hansen et al., 2012) and TIA (24–36%, Carolei et al., 2010). One explanation for the higher percentages could be visiting the patients by always the same person on the first 3 days. One might assume that the patient build a kind of personal bond. Also in course of 3, 6 and 12 months, some patients complain of headaches yet, but the prevalence decreases in that course. Only when all letters are sent for follow-up and enough time has been given for an answer, a final response rate can be determined. We suspect that the return rate is currently still low because some patients have indeed received a letter, but have not yet replied. Furthermore, possible cognitive impairment after a stroke can make it difficult to complete the questionnaires. Further results are expected during the next 12 months.