A systematic literature review of incidence and predictors of headache and migraine in survivors of haemorrhagic stroke
Background: Headache is a frequent symptom of stroke, but little is known about the true incidence of headache following a haemorrhagic stroke, or if there are any risk factors for experiencing stroke-related headache. A systematic literature review was undertaken to examine the burden of headache in haemorrhagic stroke. Methods: A systematic search of electronic databases, including MEDLINE, CINAHL, Embase, SAGE Premier, Wiley Online Library and Elsevier's ScienceDirect, with a date range of January 1990 to October 2016, for human subjects and written in English was performed. Study selection using clear criteria was undertaken, and data extraction and assessment of quality was performed. Results: Some five from a total of 27 studies met the selection criteria. A total of 483 participants were included. The pooled random effects model showed 0.5528 (95% CI 0.3756-0.7235) had headache at onset, and 0.3917 (95% CI 0.1156-0.7108) had long-term headaches. A pooled estimate for gender as a risk factor showed women had an odds ratio (OR) of 1.93 (95% CI 1.16-3.22). Conclusions: Approximately 55% of patients with intracranial haemorrhage will experience headaches at stroke onset, with a further 39% experiencing long-term headaches. Women are nearly twice as likely as men to experience headache post-intracranial haemorrhage.