ArticleThe journal of headache and pain2022
Diagnostic criteria for acute headache attributed to ischemic stroke and for sentinel headache before ischemic stroke.
Article in The journal of headache and pain, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy and safety of mesenchymal stem cells in patients with acute ischemic stroke: a meta-analysis.BMC neurology · 2024Pooled it
- Headache After Stroke: An Update for the Clinician.Current neurology and neuroscience reports · 2025Review
- Migraine-like headache attributed to a causative disorder: primary migraine or secondary headache with a migraine-like phenotype?The journal of headache and pain · 2025Article
- Transient focal neurological symptoms and headache: is it TIA or migraine with aura?The journal of headache and pain · 2025Article
- An intervention study on the secondary prevention medication adherence of ischemic stroke patients based on the protection motivation theory combined with medication literacy education in the AI-HEALS: a randomized controlled trial protocol.Frontiers in public health · 2025Article
- [Headache attributed to ischaemic stroke. An update on its semiology and diagnosis].Revista de neurologia · 2023Observational
- [Clinical relevance of headache in cerebral ischaemia].Revista de neurologia · 2023Article
- Persistent headache after first-ever ischemic stroke: clinical characteristics and factors associated with its development.The journal of headache and pain · 2022Article
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5 authors.
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Abstract
backgroundDefining the relationship between a headache and stroke is essential. The current diagnostic criteria of the ICHD-3 for acute headache attributed to ischemic stroke are based primarily on the opinion of experts rather than on published clinical evidence based on extensive case-control studies in patients with first-ever stroke. Diagnostic criteria for sentinel headache before ischemic stroke do not exist. The present study aimed to develop explicit diagnostic criteria for headache attributed to ischemic stroke and for sentinel headache.
methodsThis prospective case-control study included 550 patients (mean age 63.1, 54% males) with first-ever ischemic stroke and 192 control patients (mean age 58.7, 36% males) admitted to the emergency room without any acute neurological deficits or severe disorders. Standardized semi-structured interview forms were used to evaluate past and present headaches during face-to-face interviews by a neurologist on admission to the emergency room in both groups of patients. All headaches were diagnosed according to the ICHD-3. We tabulated the onset of different headaches before a first-ever ischemic stroke and at the time of onset of stroke. We divided them into three groups: a new type of headache, the previous headache with altered characteristics and previous unaltered headaches. The same was done for headaches in control patients within one week before admission to the hospital and at the time of entry. These data were used to create and test diagnostic criteria for acute headache attributed to stroke and sentinel headache.
resultsOur previous studies showed that headache at onset of ischemic stroke was present in 82 (14.9%) of 550 patients, and 81 (14.7%) patients had sentinel headache within the last week before a stroke. Only 60% of the headaches at stroke onset fulfilled the diagnostic criteria of ICHD-3. Therefore, we proposed alternative criteria with a sensitivity of 100% and specificity of 97%. Besides, we developed diagnostic criteria for sentinel headache for the first time with a specificity of 98% and a sensitivity of 100%.
conclusionsWe suggest alternative diagnostic criteria for acute headache attributed to ischemic stroke and new diagnostic criteria for sentinel headache with high sensitivity and specificity.
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