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Headache After Stroke: When Is It a Medical Emergency?

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Experiencing a headache after stroke can make survivors and caregivers alike grow concerned. What does it mean and what should you do?

In severe cases, a headache could be a sign of a stroke, and emergency medical attention should be called for. Although not all cases are severe, it’s important to learn about headaches after stroke to know what to do if/when it occurs.

This article will discuss potential underlying causes of headaches after stroke, effective management techniques, and when to seek immediate medical attention.

What Is the Link Between Headache and Stroke?

A stroke occurs when the supply of blood in the brain is compromised, depriving areas of oxygen-rich blood. As brain tissue is deprived of oxygen, cells begin to sustain damage. When this occurs, swift emergency treatment is needed to stop the stroke, restore blood flow in the brain, and save the person’s life.

Therefore, it is essential to understand how to recognize the most common signs of a stroke to be able to help someone receive appropriate treatment. The American Stroke Association developed the acronym F.A.S.T. to help individuals identify a stroke:

· Face: If one-half of the face is drooping, seek emergency care.

· Arm: Ask the person to raise their arms, and if one arm drifts downwards, seek emergency care.

· Speech: If the individual is slurring their speech, seek emergency care.

· Time: A stroke is a medical emergency and 911 should be called as soon as possible.

The F.A.S.T. acronym was created to summarize the most common symptoms of a stroke in a memorable way. While this helps spread awareness, it leaves out other less-common signs of a stroke such as dizziness, vertigo, confusion, sudden vision problems, and a severe headache.

Studies show that roughly 18% of patients experience a headache during the onset of their stroke. The location of the headache is sometimes influenced by the area of the brain affected. For example, when a stroke involves the carotid artery or the major artery in the neck that delivers blood to the brain, it can produce a headache in the forehead. When a stroke occurs in the vertebrobasilar system, which is responsible for supplying blood to the back of the brain, it can cause a headache at the back of the head.

When Can a Headache After Stroke Occur?

While headaches can occur during the onset of a stroke, they can also occur months down the road. Studies show that individuals who experienced a headache during the onset of their stroke are likely to experience a persistent headache roughly 1-6 months after the initial injury.

Because it’s impossible to tell if a headache is a sign of another stroke or a symptom of the aftermath, it’s important to exercise caution and seek emergency medical attention.

Headaches and Migraines After Stroke

A migraine is a severe type of headache, and a specific type of migraine is related to an increased risk of stroke: ocular migraines. These migraines occur with a visual aura, and they are related with a 2.4 times higher risk of stroke.

If your headache is severe and accompanied by a visual aura, it’s even more important to seek emergency medical attention.

Causes of Headaches After Stroke

Now that you know to seek emergency care if you or a loved one experience a headache after stroke, let’s discuss other potential causes. This information should not be used instead of seeking emergency medical treatment. Rather, it can help provide helpful information so that you can have an informed conversation with your doctor.

Other potential causes of a headache after stroke include:

1. Side Effects of Certain Medications

Some headaches may be a side effect of certain medications. If you believe your medication is causing a headache, it’s important to speak to your doctor to explore alternatives. Do not stop taking medication or add new ones before consulting your medical team.

Overusing medications such as pain medication can also result in headaches. This is because pain medication provides temporary relief for a few hours, but is often followed by a mild withdrawal that can induce pain.

2. Dehydration

Another potential cause of headaches after stroke is dehydration. Dehydration headaches occur when the body doesn’t have enough fluid, causing the tissue in your body (including your brain) to shrink. As the brain shrinks, it puts pressure on your nerves, causing a headache.

Because of the impact that dehydration has on the body and brain, it’s considered a stroke risk factor too. When the body does not have enough fluid, it can cause blood vessels to narrow and blood to thicken, raising the risk of blood clots and those clots getting trapped in an artery in the brain.

Studies have shown that about 9% of stroke survivors are dehydrated upon the event of their stroke, and dehydration is associated with worse outcomes. This is a preventable stroke risk factor that you can manage by drinking plenty of water throughout the day.

3. Withdrawal

Studies show that alcohol withdrawal and caffeine withdrawal can also cause headaches. Caffeine consumption causes blood vessels to narrow, which can reduce blood flow to the brain. When caffeine intake is reduced or stopped completely, it allows blood vessels to open up which increases proper blood flow. However, withdrawal headaches can occur as the brain adjusts to this change in blood flow.

Furthermore, alcohol intake suppresses normal neuronal activity in the brain. To compensate for this, the brain releases extra chemicals to maintain functions, and this overstimulation then becomes the “new normal” for the brain. When alcohol is removed, overstimulation may decrease which can result in discomfort and withdrawal headaches.

4. Hydrocephalus

A very serious cause of headaches after stroke is hydrocephalus. This condition involves a buildup of cerebrospinal fluid surrounding the brain and spinal cord. When the cerebrospinal fluid cannot drain properly it can increase the levels of fluid buildup. This can further result in nausea, imbalance, and thunderclap headaches, a very painful type of headache.

When hydrocephalus is present, surgical intervention may be required to drain the fluid away from the brain. The seriousness of this condition is another reason why you should seek emergency medical attention if you experience headaches after stroke.

5. Recurring Stroke

As you already know, in severe cases, headaches can be a symptom of the onset of a stroke. Therefore, if a headache comes suddenly, with or without other stroke-related symptoms, it’s important to seek immediate medical attention.

Because headaches are not as common as other stroke symptoms, they can often be misdiagnosed too. To prevent the chances of a misdiagnosis, it’s important to advocate for an MRI and/or CT scan. This can help doctors better identify a stroke if one is present.

Management Techniques for Headaches After Stroke

There are a few management techniques your doctor may recommend to help reduce headaches after stroke. For example, when headaches are caused by dehydration, your doctor may recommend drinking plenty of water and consuming water-rich fruits and vegetables.

Additionally, studies show that alcohol can contribute to dehydration but it can also cause withdrawal headaches when removed. Therefore, it’s important to consult with your doctor because they can provide better guidance on what to consume and what to avoid.

For instance, over-the-counter medications such as aspirin or ibuprofen should be avoided if you have a history of hemorrhagic stroke because it can increase the risk of bleeding. If you suspect that some of your medication is contributing to headaches after stroke, talk to your doctor to explore potential alternatives.

Headaches and migraines can be triggered by fatigue, a common effect of a stroke. Therefore, getting enough rest is important to help reduce fatigue and migraines. Talk to your doctor to explore your options if you’re having trouble sleeping due to sleep apnea or other medical conditions.

While these tips can help reduce headaches momentarily, it’s important to obtain a proper diagnosis and treat the root cause. Consult with your doctor about the types of headaches you experience, and they will provide you with the best course of treatment that is suitable and safe for you.

Understanding the Connection Between Headache and Stroke

Headaches after stroke should be taken very seriously because they could be a sign of another stroke. Although this is not a common stroke symptom, about 18% of individuals experience a headache during their stroke.

Not all headaches after stroke signify a recurrent stroke, though. Sometimes they are a result of dehydration, side effects from certain medication, or even caffeine withdrawal. To find the exact cause, it’s essential to seek emergency medical treatment and obtain an accurate diagnosis.

We hope this article helped you understand the connection between headache and stroke so that you can have an informed conversation with your doctor.

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