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KMID : 0911820160170020053
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Korean Journal of Headache
2016 Volume.17 No. 2 p.53 ~ p.56
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Acute Ischemic Stroke with Prominent Headache Symptom: A Case Series Study
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Heo Jae-Hyeok
Jang Kyoung-Hwa
Kim Byung-Kun
Ahn Jin-Young
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Abstract
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Background: Headache in stroke is usually caused by cerebral hemorrhages such as subarachnoid hemorrahge (SAH), subdural hemorrhage (SDH) and lobar hemorrhages. Acute ischemic stroke can also show headache with various neurological signs and symptoms and usually managed in emergency room. But some patient with acute ischemic stroke walks in outpatient clinic with isolated headache. We retrospectively analyzed clinical and radiological characteristics in such patients.
Methods: We conducted a retrospective review of 12 patients (male=3, female=9) who showed isolated headache diagnosed as acute ischemic stroke in outpatient clinic. We investigated their clinical features, neurological findings
and radiologic findings.
Results: All patients showed abrupt onset headache that was disappeared within 7 days. The mean age of patients was 66 year-olds. Characteristics of headache was mostly dull-aching pain (n=8) followed by throbbing pain (n=3). Thunderclap headache was presenting mode in one patient. One patient showed very mild limb weakness and 3 patients showed hemianopia. But none of the patients noticed such symptoms. The location of infarction were temporal (n=7), occipital (n=8), cerebellar (n=3) and pons (n=1) infarction in posterior circulation of brain.
Conclusion: In case of newly developed sudden onset headache without any other prominent neurological symptoms in outpatient clinic, we have to consider acute ischemic stroke, especially in elderly patients.
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KEYWORD
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Headache, Ischemic stroke, Magnetic Resonance image
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