[Prognostic value of headache in cardioembolic stroke].

OBJECTIVE

To characterize the clinical features, prognosis and clinical predictors of headache in cardioembolic stroke (CS).

METHODS

Descriptive study of 480 patients with CS included in the Sagrat Cor Hospital of Barcelona Stroke Registry over a 17 year period. The vascular risk factors, clinical profiles and topographic data in CS with and without headache were compared. The independent predictive value of each variable on the development of headache in CS was assessed with a logistic regression analysis.

RESULTS

Headache was diagnosed in 38 of 480 patients (7.9%) with CS Early neurologic deterioration was present in 40 patients (8.3%), and was significantly more frequent in patients with than without headache (17.5% vs 7%; p < 0.03). The presence of early neurologic deterioration was a significant predictive variable associated with headache in CS in the 2 logistic regression models (odds ratio [OR] = 3.34, and OR = 3.36). Other clinical variables were: cranial nerve palsy (OR = 7.54; 95% confidence interval [CI], 1.98-28.70), ataxia (OR = 4.88; 95% CI, 1.65-14.50), ischemic heart disease (OR = 3.02; 95% CI, 1.41-6.45), hyperlipidemia (OR = 2.61; 95% CI, 1.08-6.28), age (OR = 0.96; 95% CI, 0.93-0.99), and sudden onset (OR = 0.43; 95% CI, 0.21-0.91). Topographic profile were: posteroinferocerebellar artery involvement (OR = 21.41; 95% CI, 3.10-148.04), basilar artery involvement (OR = 9.04; 95% CI, 1.87-43.66) and cerebral posterior involvement (OR = 6.12; 95% CI, 2.30-16.29).

CONCLUSIONS

Headache in CS is more frequent in vertebrobasilar involvement. Headache is related with early neurological deterioration and associated with increased morbidity and mortality.