Is this constant headache related to my stroke or something else?

5 answers | Last updated: Nov 04, 2016
Helpme asked...

I recently had a stroke. Immediately after, I got a horrible headache. The stroke was on June 27th and I still have this headache. I am getting the brush off from the physician who released me after the stroke who said it was just dehydration. I was readmitted 3 days later where an MRI confirmed it was a stroke. I saw the neurologist on Monday and he prescribed medicine with no real exam. What are the possible causes of a continuous headache, that never goes away and get worse when I lie down?

Expert Answers

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

Headache is not a common symptom after a stroke.  When it occurs, a few questions go through my mind.  They include: 1) Could there have been bleeding at the location of the stroke? 2) Could there have been swelling from the stroke that caused stretching and pain in the sensitive areas around the brain? 3) Could there have been a tear in one of the arteries which caused the stroke? 4) Could there be a clot in one of the veins of the brain?  5) Could the stroke have affected one of the headache centers, usually deep within the brain?

Sometimes, headaches can happen after a stroke regardless of whether or not one of the above occurred.  I have seen patients develop chronic migraines as a result of an otherwise normal looking stroke.

It sounds like you should do two things.  First, I would ask your physican to do a complete imaging work-up, including a detailed look at the brain, the arteries of the head and neck (not just with an ultrasound of the neck), and the veins of the brain.  This can usually be accomplished by either a special MRI or a special CT (not the standard ones that most hospitals use in their routine stroke work-up).  Second, I would ask your physician to start you on one of the many chronic headache medicines - including such options as topiramate, amitriptyline, or nortriptyline - all of which are good, inexpensive, headache medicine options.

Community Answers

Antiquegranny answered...

I had a stroke in 2004 and a mini one in 2008 and both times had what I would call shooting pains in my temple area that day.However,since the strokes they seem to pretty well come more frequent when I don't get enough sleep so I try to make sure that I do.

A fellow caregiver answered...

This headache I called the Incredible Hulk Brain Stretch. The way I understand it is that the stroke can destroy brain cells, but they can reorganize and recruit from elsewhere. There is swelling in this extremely painful process. In my case, this was a sign of healing. But as mentioned above, it might be the opposite. I think a good indicator to check out is if memory capacity is returning, that is if memory loss occured. For me retrograde memory wiped out three months of memory.I am not an expert, just been there. It shocks me that few report this brain crunching pain - or do report it but it does not make it into research data.

A fellow caregiver answered...

I had a stroke in 2005 when I was 39. I am a nurse and I lifted a heavy patient, and I felt as though I pulled something in the back of my neck. I began developing headaches but didn't think too much of it because of my age and otherwise being very healthy. After taking Tylenol and Advil frequently for 3 weeks and going to work every day, I had a stroke. Severe headaches continued and different meds were tried but didn't work, until 2008 when I began taking a seizure med called Lamictal (Lamotrigine is the generic).. My Dr. said that clinical trials had been done using Seizure meds for certain types of headaches. I have never had seizures and was leery about taking it at first but I'm glad I did. Since then and my headaches have been gone and I am leading a normal life with only a few residual effects from the stroke (but nothing noticeable to others). Hope you try it and it works for you. My stroke was in the Pons and Thalamus areas.

A fellow caregiver answered...

My husband had a stroke in 2009. From that day on he has had a continuous headache. Recently, he started taking indomethacin which has helped tremendously. Please google Hemicrania Continua and try indomethacin. It may help with the pain. He also takes Lyrica and Naproxen.