Hemostasis findings in headache and psychosocial stress associated with cerebral ischemia.
We assessed the prevalence of headache and psychosocial stress in a group of patients with cerebral ischemia and evaluated hemostatic function in these patients. Headache and preceding psychosocial stress were present in one-third and one-half, respectively, of patients capable of providing an adequate history and answering a standardized psychosocial questionnaire. There were no significant differences in hematocrit, white blood cell count and differential, fibrinogen, and platelet activation peptide ß-thromboglobulin, between patients with and without headache and between high- and low-stress patients. Fibrin D-dimer (a fragment of cross-linked fibrin) was significantly lower in high-stress compared to low-stress patients. There was no association between headache and stress level. These findings make unlikely the hypothesis that headache associated with cerebral ischemia is platelet-mediated and suggest that psychosocial stress on a chronic basis is not associated with procoagulant tendencies in this population.
From the Department of Neurology, University of Southern California School of Medicine, Los Angeles, CA, U.S.A.
M
M
Fisher
The Department of Preventive Medicine, University of Southern California School of Medicine, Los Angeles, CA, U.S.A.
P J
PJ
Lee
The Department of Preventive Medicine, University of Southern California School of Medicine, Los Angeles, CA, U.S.A.
E
E
Sobel
The Department of Medicine, University of Southern California School of Medicine, Los Angeles, CA, U.S.A.
R
R
Francis