New criteria for diagnosing headache before a stroke have been developed

New criteria for diagnosing headache before a stroke have been developed

Scientists from the Ural State Medical University and the Ural Federal University for the first time in the world have developed new criteria for diagnosing headaches that occur with ischemic stroke.

Headaches can signal a stroke that has taken place or is approaching (in 3-4 days). Therefore, it is very important to determine the relationship between pathology and pain. However, the latter is diagnosed by expert judgment based on small patient samples rather than large-scale studies. Until recently, there were no criteria for diagnosing headache before a stroke.

To correct this, Ural scientists conducted research. This is reported by the Ministry of Education and Science of Russia. Doctors observed two groups of patients – with the first stroke and those who did not have serious neurological disorders and disorders. In the first group there were 550 people, in the second – 192. The study showed that a headache occurs before a stroke in a third of patients.

The research team categorized different types of headaches that people in both groups had during the year before admission to the hospital, the week before the stroke, and on the day of the stroke. They were guided by the fact that the more malaise in stroke patients differs from the usual and the less time elapses between the onset of pain and the onset of a stroke, the higher the likelihood of their causal relationship.

Thus, three types of headaches were identified: already familiar to patients, those that had never been before, and headaches with a change in characteristics (that is, they could be throbbing, more or less prolonged, accompanied by other symptoms, and so on).

New type headaches and headaches with altered characteristics prevailed in people with a stroke: about 15 percent of such patients were unwell during the last week before a stroke and another 15 percent during its onset.

The results of the work showed that about 55 percent of the surveyed from the first group felt pain of a new type, another 35 – the same, but with noticeable changes. However, none of the participants experienced unfamiliar sensations, and only two had pain with changed characteristics.

The data obtained as a result of the studies made it possible to verify the accuracy of the existing diagnostic criteria for stroke-related headaches, presented in the international classification. According to scientists, only in sixty percent of cases that the pain that occurs during the onset of a stroke met these diagnostic criteria. Therefore, they needed to be revised – the Ural scientific group modernized the criteria for headaches and developed new ones.


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