See the published version of this preprint at The Journal of Headache and Pain.
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Research article
Elena R Lebedeva
The Ural State Medical University
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2463-7113
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: There are no previous controlled studies of sentinel headache in ischemic stroke. The purpose of the present study was to evaluate the presence of such headache, its characteristics and possible risk factors as compared to a simultaneous control group.
Methods: Eligible patients (n=550) had first-ever acute ischemic stroke with presence of new infarction on magnetic resonance imaging with diffusion-weighted imaging (n=469) or on computed tomography (n=81). As a control group we studied in parallel patients (n=192) who were admitted to the emergency room without acute neurological deficits or serious neurological or somatic disorders. Consecutive patients with stroke and a simultaneous control group were extensively interviewed soon after admission using validated neurologist conducted semi-structured interview forms.
Results: Among 550 patients with stroke 94 patients (17.1%) had headache during seven days before stroke and 12 (6.2%) of controls (p<0.001; OR 3.9; 95% CI 1.7-5.8). We defined sentinel headache as a new type of headache or a previous kind of headache with altered characteristics (severe intensity, increased frequency, absence of effect of drugs) within seven days before stroke. Totally 81 patients (14.7%) had sentinel headache within the last week before stroke and one control. Attacks of arrythmia during seven days before stroke were significantly associated with sentinel headache (p=0.04, OR 2.3; 95% CI 1.1-4.8).
Conclusions: A new type of headache and a previous kind of headache with altered characteristics during one week before stroke are significantly more prevalent than in controls. Such sentinel headache should prompt urgent examination for stroke prevention.
Keywords
stroke, migraine, headache, cerebrovascular disease, sentinel headache
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View the published article at The Journal of Headache and Pain.
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Posted 29 Mar, 2020
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Reviewer #3 agreed
On 13 Apr, 2020
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Received 13 Apr, 2020
Review #3 received
Received 13 Apr, 2020
Editorial decision: Major revision
On 13 Apr, 2020
Review #1 received
Received 30 Mar, 2020
Reviewer #2 agreed
On 30 Mar, 2020
Editor assigned
On 26 Mar, 2020
Reviewers invited
Invitations sent on 26 Mar, 2020
Reviewer #1 agreed
On 26 Mar, 2020
First submitted
On 25 Mar, 2020
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On 25 Mar, 2020
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On 25 Mar, 2020
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Subject Areas
Head & Neck Surgery
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A new preprint design is coming!
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See the published version of this preprint at The Journal of Headache and Pain.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Elena R Lebedeva
The Ural State Medical University
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2463-7113
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at The Journal of Headache and Pain.
Version 1
Posted 29 Mar, 2020
No community comments so far
Reviewer #3 agreed
On 13 Apr, 2020
Review #2 received
Received 13 Apr, 2020
Review #3 received
Received 13 Apr, 2020
Editorial decision: Major revision
On 13 Apr, 2020
Review #1 received
Received 30 Mar, 2020
Reviewer #2 agreed
On 30 Mar, 2020
Editor assigned
On 26 Mar, 2020
Reviewers invited
Invitations sent on 26 Mar, 2020
Reviewer #1 agreed
On 26 Mar, 2020
First submitted
On 25 Mar, 2020
Submission checks complete
On 25 Mar, 2020
Editor invited
On 25 Mar, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Head & Neck Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at The Journal of Headache and Pain.
Background: There are no previous controlled studies of sentinel headache in ischemic stroke. The purpose of the present study was to evaluate the presence of such headache, its characteristics and possible risk factors as compared to a simultaneous control group.
Methods: Eligible patients (n=550) had first-ever acute ischemic stroke with presence of new infarction on magnetic resonance imaging with diffusion-weighted imaging (n=469) or on computed tomography (n=81). As a control group we studied in parallel patients (n=192) who were admitted to the emergency room without acute neurological deficits or serious neurological or somatic disorders. Consecutive patients with stroke and a simultaneous control group were extensively interviewed soon after admission using validated neurologist conducted semi-structured interview forms.
Results: Among 550 patients with stroke 94 patients (17.1%) had headache during seven days before stroke and 12 (6.2%) of controls (p<0.001; OR 3.9; 95% CI 1.7-5.8). We defined sentinel headache as a new type of headache or a previous kind of headache with altered characteristics (severe intensity, increased frequency, absence of effect of drugs) within seven days before stroke. Totally 81 patients (14.7%) had sentinel headache within the last week before stroke and one control. Attacks of arrythmia during seven days before stroke were significantly associated with sentinel headache (p=0.04, OR 2.3; 95% CI 1.1-4.8).
Conclusions: A new type of headache and a previous kind of headache with altered characteristics during one week before stroke are significantly more prevalent than in controls. Such sentinel headache should prompt urgent examination for stroke prevention.
Figure 1
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