ISC 2026 | Gaps in the management of post-stroke headache: insights from a meta-analysis
Bradley Ashley Ong, MD, Cleveland Clinic, Cleveland, OH, discusses gaps in the management of post-stroke headache, sharing insights from a meta-analysis of studies investigating headache after hemorrhagic stroke. Dr Ong highlights that many studies failed to apply standardized ICHD criteria or use validated disability instruments, making it challenging to draw concrete conclusions for patient populations. This interview took place at the 2026 International Stroke Congress (ISC), held in New Orleans, LA.
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Transcript
Two things that basically stood out when I was looking at the results of our study is that the field of headache, there is a gap there. And when I say gap there, the studies that we pulled together didn’t use consistent definitions of persistent headache. Many of the studies actually didn’t apply standardized ICHD criteria to diagnose someone with post-stroke headache. Sometimes we also found out that some of the studies also didn’t use like validated disability instruments...
Two things that basically stood out when I was looking at the results of our study is that the field of headache, there is a gap there. And when I say gap there, the studies that we pulled together didn’t use consistent definitions of persistent headache. Many of the studies actually didn’t apply standardized ICHD criteria to diagnose someone with post-stroke headache. Sometimes we also found out that some of the studies also didn’t use like validated disability instruments. So it’s really hard to have a concrete conclusion for these patient populations. The second is that we always have to remember that headache is not just an acute warning symptom of stroke. Back in med school, we’re always like taught that, you know, worst headache of my life would, would be a hemorrhagic stroke or a subarachnoid hemorrhage. But that is not the case because a minority or 37% of the patients would also have headaches after the stroke. And we also have to think about our questioning whenever we see these patients because they can be severely impacted in their quality of life, their work, their studies can be hampered in that sense.
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