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Headache as a symptom at stroke onset in 4,431 young ischaemic stroke patients. Results from the “stroke in young fabry patients (SIFAP1) study”

  • Neurology and Preclinical Neurological Studies - Original Article
  • Published:
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Abstract

Headache as symptom of stroke is linked to gender, history of migraine, younger age, cerebellar stroke, and low blood pressure. These associations have been controversial, large scale studies are missing. We used the stroke in young fabry patients study to examine the association of demographic, clinical and imaging factors with the occurrence of headache in 4,431 young ischaemic stroke patients (18–55 years; mean: 44.7 years) with an ischemic cerebrovascular event (CVE) (ischemic stroke—IS 75.9 %, TIA 24.1 %). Headache in males occurred more frequently in bilateral localisation (right/left/bilateral: 27.5, 24.6, 39.2 %, p < 0.01), but not in females (40.3, 34.7, 39.6 %). Headache occurrence was more often associated in both genders with IS or TIA in the posterior cerebral territory (male: 33.2 %, p < 0.05; female: 51.0 %, p < 0.01) and vertebrobasilar arteries (male: 44.8 %, p < 0.001; female: 51.2 %, p < 0.001). The larger the size of the most prominent lesion the more likely patients were complaining headache during the IS (≤1 cm vs. >half lobe: 19.5 vs. 28.4 % in male, p < 0.001; 28.9 vs. 39.1 % in female, p < 0.01). Binary logistic regression analyses revealed lower age (p < 0.001), female sex (p < 0.001), larger size of the largest lesion (p < 0.001), and localization in the vertebrobasilar territory (p < 0.001) as predictors for headache during CVE. Headache at stroke onset is more common during IS in females, younger patients, with greater size of the acute lesion, and affected in posterior cerebral artery or vertebrobasilar system. Headache is a leading symptom in specific combination of stroke factors. These factors should be taken into account when patients report headache during IS or TIA.

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Conflict of interest

All authors declare that they have no conflict of interest. Sifap study (Stroke in Young Fabry Patients, http://www.sifap.eu; ClinicalTrials.gov: NCT00414583) has been supported partially by an unrestricted scientific grant from Shire Human Genetic Therapies. The sponsors of the study had no role in the study design, data collection, data analysis, interpretation, writing of the manuscript, or the decision to submit the manuscript for publication. The academic authors had unrestricted access to the derived dataset, and assume full responsibility for the completeness, integrity and interpretation of the data, as well as writing the study report and the decision to submit for publication.

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Authors and Affiliations

  1. Institute of Medical Psychology and Medical Sociology Medical Faculty, University of Rostock, Gehlsheimer, Straße 20, 18147, Rostock, Germany

    Peter Kropp

  2. Institute of Biostatistics and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, Berlin, Germany

    Martin Holzhausen

  3. Department of Neurology, New York University School of Medicine, New York, NY, USA

    Edwin Kolodny

  4. Department of Neurology, University of Dresden, Dresden, Germany

    Ulf Becker

  5. Institute for Stroke and Dementia Research, Medical Center Großhadern, Klinikum der Universität München, Munich, Germany

    Martin Dichgans & Anna Karpinska

  6. Department of Neurology and Stroke Center. La Paz University Hospital. IdiPaz Health Research Institute, Autonoma University of Madrid, Madrid, Spain

    Exuperio Diez-Tejedor & Blanca Fuentes

  7. Department of Neurology and Section of Neuroradiology Department of Radiology, Medical University of Graz, Graz, Austria

    Christian Enzinger

  8. Department of Neurology, Medical University of Graz, Graz, Austria

    Franz Fazekas

  9. Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK

    Wolfgang Meyer

  10. Department of Neurology, University of Giessen, Giessen, Germany

    Christian Tanislav

  11. Department of Neurology, Medical Center Großhadern, Klinikum der Universität München, Munich, Germany

    Anna Karpinska

  12. Dietrich-Bonhoeffer-Klinikum, Klinik für Neurologie, Neubrandenburg, Germany

    Tobias Böttcher

  13. Albrecht-Kossel-Institute, Medical Faculty, University of Rostock, Rostock, Germany

    Tobias Böttcher & Arndt Rolfs

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  1. Peter Kropp
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  2. Martin Holzhausen
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  3. Edwin Kolodny
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  4. Ulf Becker
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  5. Martin Dichgans
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  6. Exuperio Diez-Tejedor
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  7. Christian Enzinger
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  8. Franz Fazekas
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  9. Blanca Fuentes
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  10. Anna Karpinska
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  11. Wolfgang Meyer
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  14. Arndt Rolfs
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Stroke in Young Fabry Patients (sifap) Investigators

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Correspondence to Peter Kropp.

Additional information

Collaborators are Adam L, Aichner F, Allendörfer J, Aurich K, Bach E, Bähr D, Baranowska A, Baron P, Barrows RJ, Basic V, Becker U, Benecke R, Beridze M, Berrouschot J, Bersano A, Biedermann C, Blazejewska-Hyzorek B, Bodamer O, Borchert A, Bornstein N, Bosner-Puretic M, Böttcher C, Böttcher T, Boy S, Boysen G, Brämer D, Brandtner M, Brosig TC, Brouns R, Brüderlein K, Budisic M, Burmeister J, Chatzopoulos M, Cho TH, Choe CU, Crome O, Curtze S, Czlonkowska A, Dani K, De Brabander I, de Sousa AI, DeDeyn P, Demarin V, Derex L, Deuschl G, Dichgans M, Díez-Tejedor E, Dörr A, dos Santos IM, Dudesek A, Duning T, Dzagnidze A, Dzialkowski I, e Silva AA, Ebinger M, Ebke M, Enzinger C, Ermis U, Ertl GM, Eschenfelder CC, Fazekas F, Federow I, Fehm NP, Fellgiebel A, Ferrari J, Fink I, Flamm-Horak A, Fleischer K, Frandlih L, Fuentes B, Furtner M, Gahn G, Gattinoni M, Gaul C, Gerhardt I, Giese AK, Ginsberg M, Grittner U, Gube C, Günther A, Hacke W, Hallenberger K, Hamer H, Hanso H, Hanssen JR, Haring HP, Hartung HP, Heide W, Heidler F, Hendrich C, Hennerici MG, Henseler C, Hentschel H, Herzau C, Hillen U, Hirsekorn J, Hobohm C, Holzhausen M, Hoppe J, Horber K, Horner S, Huber R, Hulsbosch C, Iwanow J, Jander S, Janelidze M, Jauss M, Jegzentis K, Jonas L, Jungehulsing GJ, Jurašić MJ, Kampmann C, Kaps M, Karpinska A, Kessler C, Khaw A, Kinsella J, Kiszka M, Kleinen C, Klingelhöfer J, Kloppig W, Knauer K, Knoflach MH, Köhne A, Kolbaske S, Kolodny E, König F, Kopacevic L, Krenn U, Krieger D, Kropp P, Krützelmann AC, Kuhlenbäumer G, Küppers-Tiedt L, Lackner K, Lang W, Langos R, Lardurner G, Laue M, Lautenschläger C, Lemmens R, Leth Jeppesen L, Levsen M, Leypoldt F, Lichy C, Lilek S, Liman T, Link T, Lischka-Lindner A, Liske B, Lobjanidze N, Loui H, Lourenco M, Ludolph AC, MacDougall N, Machado Candido J, Mädl J, Magnus TU, Makowei G, Mallia M, Marcelis E, Marecek SM, Markus H, Marquardt L, Martínez-Sanchez P, Martus P, Mascher H, Matzen P, McCabe DJH, Meier H, Melms A, Mermolja Günther K, Metso M, Mette R, Metz A, Mewald Y, Meyer W, Michalski D, Muir K, Müller P, Müller T, Murphy RP, Nabavi DG, Narr S, Neumann-Haefelin T, Nieber E, Niemann D, Norrving B, Nowe T, Objartel A, Oschmann P, Otto D, Pape O, Paschke E, Pendl B, Pérez-Guevara MI, Petersen A, Platte B, Platzen J, Pluta-Fuerst A, Pott M, Prantl B, Prell T, Preuth N, Putaala J, Raubold S, Reichmann H, Richter D, Riess O, Ringelstein EB, Rokicha A, Rolfs A, Ropele S, Rosenkranz M, Rösner S, Rothhammer V, Rothwell PM, Rowe A, Schilling M, Schlachetzki F, Schmidt R, Schmidt W, Schneider D, Schneider M, Schreiber W, Schrotter G, Schuhmann C, Schulte D, Schultes K, Schultze C, Schulz A, Schwarz S, Schwarze J, Sehr B, Sheorajpanday R, Siebler M, Sinadinowska D, Singer OC, Smith W, Spiegel M, Stadler C, Stangenberg D, Steinbach I, Sterner E, Sternitzky C, Stoll A, Straub V, Sulzer C, Tanislav C, Tatlisumak T, Thijs V, Thomä M, Thomalla G, Tobin O, Tranjec Z, Trummer U, Übelacker A, Ulrich E, Urban D, van de Loo S, Vella N, Venables G, Villringer A, Walleczek AM, Wartenberg K, Weber JR, Wegener N, Weidemann F, Weise C, Welch A, Wille A, Willeit J, Windisch M, Witte OW, Wodarg F, Yperzeele L, Zerbs A, Zielke S, Ziemssen T, von Sarnowski B, Zierz S, Zimmermann P, Zollver A.

Peter Kropp, Martin Holzhausen, and Edwin Kolodny contributed equally to this study.

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Kropp, P., Holzhausen, M., Kolodny, E. et al. Headache as a symptom at stroke onset in 4,431 young ischaemic stroke patients. Results from the “stroke in young fabry patients (SIFAP1) study”. J Neural Transm 120, 1433–1440 (2013). https://doi.org/10.1007/s00702-013-1014-0

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  • DOI: https://doi.org/10.1007/s00702-013-1014-0

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