ABSTRACT NUMBER: ESOC2026A806 RELATION OF POST-STROKE HEADACHE TO CEREBROVASCULAR PATHOLOGY AND HEMODYNAMICS

Abstract Background and aims Despite the high prevalence of cerebrovascular stroke, headache attributed to ischemic strokes is often overlooked. The aim is to detect the relation of a post-stroke headache to cerebrovascular pathology and hemodynamics changes through a duplex ultrasound examination. Methods This prospective case–control study was conducted at Kasr Al-Ainy and Al-Azhar University hospitals from January to August 2021. A total of 239 patients with acute ischemic stroke were enrolled and classified into two groups: patients with stroke-related headache (cases) and headache-free stroke patients (controls). All patients underwent assessment of headache characteristics and vascular risk factors, clinical and radiological evaluation of stroke type, and extracranial and intracranial cerebrovascular duplex ultrasonography. Results Group I included 112 patients (mean age 57.66 ±6.59 years), Group II included 127 patients (mean age 57.73±7.89 years). Post-stroke headache was more frequent in patients with posterior circulation infarction (58%). Post-stroke headache was reported within 7 days post-stroke in (61.6%) of patients. Pre-stroke headache was an independent predictor for post-stroke headache occurrence (OR=28.187, 95%CI; 6.612-120.158, P<0.001). Collateral opening and various degrees of intracranial vascular stenosis were strong predictors of headache occurrence (OR=25.071, 95% CI; 6.498-96.722, P<0.001). Conclusions Post-stroke-headache is a common phenomenon especially in patients with pre-stroke headache, history of old stroke, posterior circulation infarction, and large artery disease. This headache was of moderate-intensity with clinical characteristics of tension-type. The intracranial cerebrovascular pathological changes including opening of the collateral channels and variable degrees of stenosis of cerebrovascular systems were implicated in the production of that headache. Conflict of interest nothing to disclose