2025 American Academy of Neurology Abstract Website

Objective:

Headache is a common complaint among patients undergoing endovascular therapy (EVT) for acute ischemic stroke, particularly those with right middle cerebral artery (MCA) involvement. However, comprehensive studies on post-EVT headaches are lacking in the literature. To address this gap, a retrospective analysis was conducted to investigate the incidence of headaches in individuals with right MCA ischemic stroke who received EVT.

Background:

Headache is commonly seen in posterior circulation strokes and there have been studies looking at the type of headache after stroke. The most common type of headache after stroke is tension type headache. The idea for this study arose after it was observed that many patients that underwent mechanical thrombectomy complained of a right sided migraine type headache.

Design/Methods:

Data from the "NeuroIR Patient" database at Banner University in Phoenix, AZ, from January 2022 to December 2023 was analyzed. Patients were asked to report headaches for recording in this database. The impact of EVT on headache incidence in patients with right MCA ischemic stroke was evaluated, adjusting for potential confounders such as thrombolytic use, hemorrhagic conversion, and missing data.

Results:

Among the 382 acute ischemic stroke patients reviewed, 127 (33.2% of the total) had right MCA ischemic stroke, with 17 (13.4% of right MCA strokes) reporting headaches. Of those patients, 10 (58.8% of right MCA strokes with headaches) met inclusion criteria, indicating a potentially increased incidence of headaches in EVT recipients. Demographic analysis showed no differences in sex, with ages ranging from 51 to 83 years.

Conclusions:

Our study highlights headaches as a significant symptom in some patients with right MCA ischemic stroke post-EVT. Limited literature exists on headache incidence in this population, emphasizing the need for further research in this area.