HEADACHE IN ACUTE ISCHEMIC CEREBROVASCULAR-DISEASE - PROSPECTIVE CLINICAL-STUDY OF 195 PATIENTS

BACKGROUND: Headache is a little known aspect in the study of acute is chemic cerebrovascular disease (AICVD). METHODS: To contribute to the knowledge of the clinical characteristics of headache in the different nosologic entities of AICVD a prospective study was performed in 195 patients consecutively studied by CT scan and/or cerebral MRI. RESULTS : There was headache in 32 % of the total and in 41 % of the thromboti c infarctions, 39 % of the cardioembolisms, 26 % of the transient isch emic attacks (TIA) and 23 % of the lacunar infarcts. The mean duration was 25 +/- 28 hours. Headache was focal in 74 % of the cases and of s lihg or moderate intensity in 74 %. Headache was significantly more co mmon in thrombotic infarctions than in lacunar ones (p < 0.05). It was more frequent when the topography is vertebrobasilar (57.5 %), in com parison with carotid (21 %) or indetermined (17.5 %) (p < 0.0001). Hea dache was more commmon when topography was cortical (56.5 %) in compar ison with subcortical (26.5 %) (p < 0.005). Eight per cent of the pati ents presented sentinel headache: 22 % of the cardioembolic infarction s, 7 % of the lacunars, 6.5 % of the TIA and 5.5 % of the thrombotic. CONCLUSIONS: Headache in acute ischemic cerebrovascular disease is not uncommon predominating in thrombotic infarctions and cardioembolisms of cortical topography and of vertebrobasilar vascullar territory.