Data from: Headache after ischemic stroke: a systematic review and meta-analysis

Objective: Headache associated with ischemic stroke is poorly understood. To gain further insight, we systematically reviewed studies examining the prevalence and characteristics of new onset post-stroke headache. Methods: Medline and PubMed databases were queried. 1812 articles were identified. Of these, 50 were included in this systematic review. Twenty were included in a meta-analysis and meta-regression. Results: Headache occurred in 6-44% of the ischemic stroke population. Most headaches had tension-type features, were moderate to severe and became chronic in nature. Meta-analysis using an inverse-variance heterogeneity model revealed a pooled prevalence of 0.14 (95%CI 0.07 – 0.23) with heterogeneity among studies. Meta-regression revealed a significant association between prevalence and study location, the source population's national human development index (HDI), and study quality. We found higher prevalence in European (0.22, 95%CI 0.14 – 0.30) and North American (0.15, 95% CI 0.05 – 0.26) studies compared with Middle eastern and Asian studies (0.08, 95% CI 0.01 – 0.18). However, within each region, populations from countries with higher HDI (p=0.03) and studies with higher quality (p=0.001) had lower prevalence. Calculated crude odds ratios showed that posterior circulation stroke (pooled OR 1.92, 95%CI 1.4-2.64; n=7 studies) and female sex (pooled OR 1.25, 95%CI 1.07-1.46; n=11 studies) had greater odds of headache associated with ischemic stroke. Conclusions: Taken together, these data suggest that headache is common at the onset of or shortly following ischemic stroke and may contribute to post-stroke morbidity. Better understanding of headache associated with ischemic stroke is needed to establish treatment guidelines and inform patient management.