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Folia Neuropathologica
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abstract:
Case report

Headache attributed to ischemic stroke – a new scope for management: a case study

Elsayed Abed
1
,
Ahmad Farag El-adawey
1
,
Mohamed Hamed Rashad
1
,
Ahmed Hassan Elsheshiny
1
,
Ali Mahmoud Ali
1
,
Fathy Mahmoud Mansour
1
,
Abdel-Ghaffar Fayed
1
,
Mohammad Fathi Abdulsalam
1
,
Shaimaa Sayed Khater
2

  1. Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
  2. Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Folia Neuropathol 2024; 62:
DOI: https://doi.org/10.5114/fn.2024.139138
Online publish date: 2024/04/23
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Acute ischemic stroke may present with serious clinical manifestations. Headache attributed to ischemic stroke is one of these clinical manifestations which may be neglected and affect the functional outcome of the patients. Understanding the exact pathophysiology, and recognition of the most clinical and radiological predictors can help to provide good management and open scope for prophylactic approaches. Here, we report a case presented with acute onset of ischemic stroke and developed a new onset headache on the first day of stroke onset. According to the International Classification of Headache Disorders third edition (ICHD-3), the patient has a post-stroke headache. Using transcranial duplex ultrasound, activation of the trigeminovascular pathway could be attributed to the opening of more pain-sensitive collateral channels as the left posterior communicating artery (P Com A). In conclusion, we can predict the development of acute headache at stroke onset based on different clinical and radiological factors. Opening of the collateral channels is strongly implicated in the production of post-stroke headache.
keywords:

post-stroke, acute headache, duplex, collateral
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