Onset Headache Predicts Good Outcome in Patients With First-Ever Ischemic Stroke

• DOI: 10.1161/strokeaha.113.677070
• Publication Date: 2013-05-24T05:26:39Z
• Authors: Ping-Kun Chen; Pai-Yi Chiu; I-Ju Tsai; Hung-Pin Tseng; Jiunn-Rong Chen; Shoou-Jeng Yeh; Shin-Joe Yeh; Jau-Jiuan Sheu; Chih-Ping Chung; Ming-Hisu Wu; Chaur-Jong Hu; Chun-Yuan Chang; Cheng-Yu Wei; Ping-Keung Yip; Sheng-Feng Sung; Shuu-Jiun Wang; Chung Y. Hsu
• Keywords: Stroke

Background and Purpose— The study aimed to assess whether onset headache is an ominous sign in patients with first-ever ischemic stroke. Methods— A large population of stroke was obtained from the Taiwan Stroke Registry. subtypes were classified by Trial ORG 10172 Acute Treatment (TOAST) criteria. On basis International Classification Headache Disorders, second version, defined as a new that developed at Clinical features impact on outcomes, including in-hospital evolution, changes National Institutes Health Scale discharge, Barthel index modified Rankin scale ≤6 months after compared between those without headache. Results— Among 11 523 stroke, 848 had (7.4%). Patients specific cause, large-artery atherosclerosis, or cardioembolism more likely have younger, predominantly female, posterior circulation lesions. Compared headache, lower frequency evolution (4.5% versus 6.7%; adjusted relative risk, 0.64; 95% confidence interval, 0.52–0.79), greater improvement score discharge (0.08 −0.20; P =0.02), higher mean scores (86.5±20.0 83.9±23.3; difference, 1.43; 0.28–2.89), than 2 (27.6% 31.5%; 0.85; 0.72–0.95) 1-month follow-up. There also trend for better functional outcome 3- 6-month follow-ups. Conclusions— By adopting standard classification criteria, this large-scale demonstrated associated modest but significantly outcomes