Are my symptoms consistent with my stroke?

A fellow caregiver asked...

Hi. I had an ischemic venous stroke in the occipital lobe eight months ago. Can central pain syndrome (cps)(thalamic syndrome) occur if the stroke did not involve the thalamus? I don't have any symptoms of CPS except a severe burning headaches daily. I thought cps involved the limbs and not headaches. I don't have hypersensitivities anywhere including the face. Thanks.

Expert Answer

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

The short answer is "yes", that pain syndromes can develop from various different strokes, not just in the thalamus.

You mention that yours was a "venous" stroke, which are quite rare. Given that, a more bizarre set of symptoms would be expected to follow than would be typical with an arterial stroke, including chronic headaches. In general, as long as you are on the proper blood thinner, and there is no new dangerous change on follow-up imaging, I would recommend treating the symptoms (if very bothersome to you) with medication. Less expensive options include gabapentin or amitriptyline. More expensive, brand name, options would include Lyrica and/or Cymbalta. I typically do not use the latter two medications unless you have already tried and failed (or have medical contraindications to) the less expensive options. All of these medications can give good symptom relief, typically with minimal side effects.

Good luck!