Headache at the Chronic Stage of Ischemic Stroke.

Background: Headache in ischemic stroke survivors after the acute stage is incompletely described. Objective: We aimed to prospectively describe the characteristics of headache and the predictors of headache at the chronic stage after ischemic stroke. Methods: We conducted a prospective observational cohort study including 102 acute ischemic stroke patients admitted to a Stroke Unit. Patients were interviewed at the acute and the chronic stage (12 months after stroke). Characteristics of those headaches were collected using a previously validated headache questionnaire enabling headache classification following the International Headache Society criteria. Pre‐stroke headache history was registered using the same instrument. Results: Forty‐five patients out of 89 with completed follow‐up (51%) reported headache at the chronic stage. In most of the patients, headache was sporadic, mild, pressure‐like, with a duration of minutes to hours, with characteristics of tension‐type headache in 51% (n = 23/45). Headache was a reactivation of pre‐stroke headache in 33% (n = 15/45), different from pre‐stroke headache in 44% (n = 20/45), and of new‐onset in 22% (n = 10/45). Only 1 patient had a new‐onset headache at the acute stage that persisted with the same characteristics at the chronic stage. Pre‐stroke headache (OR = 5.3; 95% CI [2.01‐13.98] P =.001) and female sex (OR = 3.5; 95% CI [1.3‐9.4] P =.013) predicted headache at the chronic stage after stroke, controlling for age, severity, and location of stroke. Conclusions: Headache in ischemic stroke survivors at the chronic stage is more frequent in women and in patients with pre‐stroke headache. It is most frequently a headache with different characteristics of the pre‐stroke headache and only rarely a new‐onset headache starting at the acute stage and persisting at the chronic stage. [ABSTRACT FROM AUTHOR]