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Headache was reported by 16%of the patients with infarct and 36%of those with haemorrhage(p<0.001).The prevalence of headache was 9%with lacunar infarct,15%with middle cerebral artery territory infarct,37%with infratentorial haemorrhage,and 36%with supratentorial hemorrhage.The most common topography of pain was frontal(41%),followed by diffuse headache (27%);p<0.001).Diffuse(41%)or occipital(30%)headache was particularly frequent with posterior circulation stroke,whereas frontal headache was associated with anterior circulation stroke(51%;p<0.001).Headache in stroke may be explained in part by involvement of blood vessels(acute distention or distortion)and mechanical(stretch of haemorrhage)stimulation of intracranial nociceptive afferents.Stroke due to dissection was strongly associated with headache(p<0.001),whereas embolic(cardiac,artery to artery)stroke was more common without headache(p<0.001),emphasizing the role of extracranial v intracranial arteries in the genesis of headache at stroke onset.Moreover,dual trigeminal-vascular and cervical-vascular system involvement in causing headache may explain the lack of correspondence with the"rules of referral"in up to 38%of the cases. |
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arterial dissection
arterial dissection,carotid
cerebral infarction
cerebral infarction,hemorrhagic
cerebrovascular accident
headache
headache,bilateral
headache,cerebrovascular disease causing
headache,frontal
headache,location
intracerebral hemorrhage
lacunar infarction
review article
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