title: Headache as a surrogate marker of the molecular mechanisms implicated in progressing stroke.
abstract: The mechanism for headache in patients with acute ischaemic stroke are not completely understood. We analysed the relationship between headache and the early worsening of neurological symptoms in patients with acute ischaemic stroke, and we studied the possible biochemical mechanisms implicated. Headache at the onset of ischaemic stroke predicted progression with a sensitivity, specificity, and positive predictive value of 56%, 99%, and 98%, respectively. CSF concentrations of glutamate, Interleukin-6, and NO-m were significantly greater in patients with progressing stroke than in patients with nonprogressing stroke, and these biochemical markers were also significantly higher in patients with headache than in those without headache. Results of this study suggest that headache at the onset of ischaemic stroke is an independent predictor of neurological worsening and we hypothesize that headache might be a surrogate marker of the molecular mechanisms involved in neurological worsening after acute stroke.
authors.affiliation: Department of Neurology, Hospital Clínico Universitario and Universidad de Santiago de Compostela, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Leira
authors.forename: A
authors.initials: A
authors.lastname: Dávalos
authors.forename: A
authors.initials: A
authors.lastname: Aneiros
authors.forename: J
authors.initials: J
authors.lastname: Serena
authors.forename: J M
authors.initials: JM
authors.lastname: Pumar
authors.forename: J
authors.initials: J
authors.lastname: Castillo
mesh_terms: D000208:Acute Disease; D000368:Aged; D015415:Biomarkers; D001786:Blood Glucose / Q000032:analysis; D002545:Brain Ischemia / Q000134:cerebrospinal fluid / Q000150:complications* / Q000503:physiopathology; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005971:Glutamates / Q000134:cerebrospinal fluid; D006261:Headache / Q000134:cerebrospinal fluid / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D015850:Interleukin-6 / Q000134:cerebrospinal fluid; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D005971:Glutamates; D015850:Interleukin-6; D009569:Nitric Oxide