Headache after stroke is fairly common. These headaches often have features similar to tension-type headache and may be more severe than pain during the stroke itself.
Strokes occur due to a sudden interruption in oxygen-rich blood supply to the brain, leading to tissue damage or the death of brain cells. This can cause changes in the brain that lead to persistent pain after the stroke is over. Headaches can also develop as a side effect of certain medications.
Continue reading for more information on headache after stroke and potential treatment options.
Most people do not experience persistent headache after a stroke. However, it is a common complication.
Some research indicates that around
Anyone experiencing a headache after a stroke should seek medical advice. A doctor can diagnose the headache, identify underlying causes, and recommend appropriate treatments.
If the headache continues to get worse, comes on suddenly, or is severe, a person should get immediate medical help.
People who have recently had a stroke can experience another stroke, so dial 911 if the headache occurs with any of the following stroke symptoms:
- facial drooping
- new numbness or weakness in the arms, legs, or on one side of the body
- sudden difficulty speaking or understanding speech
- sudden difficulty seeing with one or both eyes
- sudden difficulty walking
Headache after stroke may occur for several reasons, such as:
- Changes in the brain: Post-stroke headache may develop due to changes in the brain that occur during the stroke, when part of the brain lacks adequate blood flow. These changes may affect blood vessels and lead to headaches or migraine episodes.
- Medications: Headaches be a side effect of post-stroke medications, including pain relievers.
- Hydrocephalus: A type of stroke known as subarachnoid hemorrhage can occur due to hydrocephalus. This condition causes a buildup of cerebrospinal fluid around the brain, which can lead to headaches, balance problems, and nausea.
- Other conditions: Other conditions that can cause headache, such as obstructive sleep apnea or musculoskeletal problems, may contribute to a post-stroke headache or lead to it becoming persistent.
After a stroke, a person is at
Some risk factors for post-stroke headache include:
- younger age
- being female
- having a preexisting headache disorder
- having post-stroke depression or fatigue
These factors appear to make post-stroke headache more likely, but they do not guarantee a person will develop this symptom.
Often, headaches after stroke resemble tension headaches, which cause a dull, aching pain and pressure that feels like a band around the head. Post-stroke headaches tend to be severe.
However, the symptoms of post-stroke headache may vary depending on the type of stroke a person had and its location.
For example, if a stroke affects the carotid artery, the primary artery in the neck that delivers blood to the brain, it can cause a headache in the forehead.
On the other hand, if a stroke occurs in the vertebrobasilar system, which is responsible for supplying blood to the back of the brain, it can trigger a headache at the top of the neck.
Less commonly, people experience migraine-like symptoms following a stroke, which include headache, nausea or vomiting, and sensitivity to light or sound.
Migraine can also cause an aura shortly before the pain. Aura symptoms can include:
- visual changes, such as seeing flashing lights
- skin sensations, such as numbness or tingling
- difficulty speaking, which may cause slurring or mumbling
People who experience migraine with aura have a
A doctor may diagnose headache after stroke based on symptoms and medical history alone. However, in some cases, they may order other tests to rule out underlying conditions. These may include:
- neurological exams
- CT or MRI scans
- testing of cerebrospinal fluid
There is a lack of research on treatments that work specifically for post-stroke headaches. Doctors may recommend a combination of medications and approaches that can treat other headache types, such as:
- Medications: A doctor may recommend medications such as acetaminophen (Tylenol) or prescription drugs to relieve pain. If a person has migraine, a doctor may recommend drugs such as gepants and ditans.
- Hydration: Dehydration can contribute to headaches, so staying hydrated may reduce them. Dehydration is also a stroke risk factor. If the body does not have sufficient fluid, blood vessels narrow and the blood thickens, raising the risk of clots. A 2019 study states that about
9%of people who experienced a stroke were dehydrated at the time.
- Lifestyle changes: If a person has specific headache triggers they can identify, making changes in their routine, diet, or home may help with avoiding them.
- Botox: Botox injections can sometimes help reduce migraine pain or frequency.
- Complementary therapies: Some people may find complementary therapies, such as acupuncture or biofeedback, helpful as an addition to their treatment plan.
A person needs to speak with a doctor before trying any medications, including over-the-counter drugs, for post-stroke headache. Some medications may be risky or interact with other medications a person is taking.
For example, people who have had a hemorrhagic stroke
If a person believes their medications are causing a headache, they must speak with their doctor to explore alternatives rather than stopping the medication suddenly.
Post-stroke headache should improve over time, notes the
According to a 2019 review, a person developing a brand-new headache after an ischemic stroke is a predictor of them still having persistent headache 6 months later.
Headache after stroke is a relatively common complication. It may occur due to changes in the brain, medication side effects, or dehydration. In some situations, a sudden or severe headache with other symptoms may indicate another stroke.
People can experience different types of headache after stroke, but the headache often resembles a tension-type headache. Treatment may involve taking pain medication, avoiding triggers, staying hydrated, or trying complementary therapies.
If a person experiences headache after stroke, consulting a doctor can help them rule out any underlying conditions and start any recommended treatments.