ABSTRACT NUMBER: ESOC2026A808 PREDICTORS OF ACUTE HEADACHE AT STROKE ONSET: A PROSPECTIVE STUDY; CLINICAL AND RADIOLOGICAL EVALUATION

Abstract Background and aims Predictors of Acute Headache at Stroke Onset Are Overlooked; This Study Assesses Clinical and Radiological Factors to Improve Management. Methods This observational case–control study included 112 patients with post-stroke headache (per ICHD-3) and 127 matched controls without headache, conducted from January to August 2021 at Kasr Al-Ainy and Al-Hussein University hospitals. Building on our previous study linking post-stroke headache to cerebrovascular and hemodynamic changes via duplex ultrasound, this study focuses on identifying clinical and radiological predictors of post-stroke headache. Results The case group included 112 patients and the control group 127 matched patients. Significant differences were found for history of sleep deprivation, psychological stress, BMI >25, pre-stroke headache, previous stroke, and posterior circulation infarction with large artery disease (P<0.001). Multiple lacunar infarctions and leukoaraiosis were the most frequent radiological findings in cases (P<0.001). Posterior circulation infarcts, especially cerebellar (34%), and infarcts >15 mm were significantly associated with post-stroke headache (P<0.001). Conclusions We can predict the development of acute headache attributed to stroke onset through several clinical and radiological factors. On the concept of post-stroke headache was developed within 7 days after stroke onset in most of the case group, our study could help further studies with a new scope to provide better prophylactic management for a post-stroke headache once we predict it. Conflict of interest Nothing to disclose