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Clinical Implications of Headache in Lacunar Stroke: Relevance of Site of Infarct
Author(s) -
Arboix Adrià,
GrauOlivares Marta,
GarcíaEroles Luis,
Massons Joan,
Comes Emili,
Targa Cecilia
Publication year - 2006
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/j.1526-4610.2006.00507.x
Subject(s) - medicine , white matter , infarction , lacunar stroke , stroke (engine) , cardiology , cerebral infarction , radiology , magnetic resonance imaging , ischemic stroke , ischemia , myocardial infarction , mechanical engineering , engineering
Objective.—To assess whether the infarction topography influenced upon the incidence of headache and the likelihood of neurological recovery in lacunar infarction. Background.—The relationship between topography of infarction and the incidence of headache as well as the influence of headache on neurological outcome in patients with lacunar stroke are still unclear. Methods.—In a cohort of 387 patients with neuroimaging‐proven acute lacunar infarction collected from a prospective hospital‐based stroke registry over a 12‐year period, 43 patients (11.1%) presented with headache within a 72‐hour interval of stroke onset. Results.—Headache was more common in deep brain gray matter or brainstem lacunar infarction than in supratentorial white matter lacunar infarction (14.9% vs 8%, P < .033), but lacunar infarctions in the supratentorial white matter had less frequently absence of limitation at discharge (15.1% vs 25.1%, P < .013). In deep brain gray matter or brainstem lacunar infarction, early neurological recovery decreased from 26.2% to 19.2% when headache was present at stroke onset. In the multivariate analysis, dysarthria‐clumsy hand and absence of headache in deep brain gray matter or brainstem lacunar infarction were independent predictors of favorable outcome. Conclusions.—In patients with lacunar infarction, headache at stroke onset was more common in deep brain gray matter or brainstem topographies than in supratentorial white matter lesions. In deep brain gray matter or brainstem lacunar infarctions, early neurological recovery was less likely when headache was present.