Pain following stroke: A prospective study

Hansen, Anne P.; Marcussen, Ninna S.; Klit, Henriette; Andersen, Grethe; Finnerup, Nanna Brix; Jensen, Troels Staehelin

doi:10.1002/j.1532-2149.2012.00123.x

Cited by 150 publications

(174 citation statements)

References 26 publications

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“…Those with a history of tension-type or vascular headache are more likely to develop headache with or after stroke [121]. In general, post-stroke headache has been characterized as a tension-type headache that has a pressing quality, and is not aggravated by movement [33,122]. …”

Section: Post Stroke Headachementioning

confidence: 99%

“…Headache at stroke onset is shown to be predictive of headache at 6 months post-stroke [33]. Those with a history of tension-type or vascular headache are more likely to develop headache with or after stroke [121].…”

Section: Post Stroke Headachementioning

confidence: 99%

“…These are commonly used in studies of PSP to define pain subtypes [28,29,30,31,32]. The commonest types of PSP are central post-stroke pain (CPSP), pain secondary to spasticity, shoulder pain, complex regional pain syndrome (CRPS), and headache [5,33]. Many patients report more than one pain subtype [2], with common combinations being CPSP and spasticity, or CPSP and shoulder pain [5].…”

Section: Common Post-stroke Pain Subtypesmentioning

confidence: 99%

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Post Stroke Pain: Identification, Assessment, and Therapy

2015

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Background: Pain is a common complication after stroke and is associated with the presence of depression, cognitive dysfunction, and impaired quality of life. It remains underdiagnosed and undertreated, despite evidence that effective treatment of pain may improve function and quality of life. Summary: We provide an overview of the means for clinical assessment and risk factors for the development of post-stroke pain, then review the newest available literature regarding the commonest post-stroke pain syndromes, including central post-stroke pain, complex regional pain syndrome, musculoskeletal pain including shoulder subluxation, spasticity-related pain, and post-stroke headache, as well as the available epidemiology and current treatment options. Key Messages: In the best interests of optimizing quality of life and function after stroke, clinicians should be aware of pain as a common complication after stroke, identify those patients at highest risk, directly inquire as to the presence and characteristics of pain, and should be aware of the options for treatment for the various pain syndromes.

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Section: Post Stroke Headachementioning

confidence: 99%

Section: Post Stroke Headachementioning

confidence: 99%

Section: Common Post-stroke Pain Subtypesmentioning

confidence: 99%

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Post Stroke Pain: Identification, Assessment, and Therapy

2015

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“…However, cerebral infarction was detected in 30% of the patients. Considering that cerebral infarction and ischemia can be causes of headache and dizziness, headache with infarction or severe ischemia should be classified as symptomatic MMD [9,10,11]. If a different treatment strategy can be applied to asymptomatic MMD from symptomatic disease, the definition should be strictly limited.…”

Section: Discussionmentioning

confidence: 99%

Clinical Course of Asymptomatic Adult Moyamoya Disease

Jo¹,

Yeon²,

Hong³

et al. 2014

Cerebrovasc Dis

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Background: As regular medical check-ups are becoming more common, the prevalence of asymptomatic moyamoya disease (MMD) is increasing. However, the definition and clinical features are still unclear. The lack of precision has hampered the establishment of guidelines for the management of asymptomatic MMD. The purpose of this study was to define and clarify the clinical characteristics of asymptomatic MMD in adults. Methods: We identified all adults (aged ≥18 years) with MMD who underwent digital subtraction angiography or magnetic resonance angiography at our institution from 1995 through 2010. The authors defined asymptomatic MMD as asymptomatic or nonspecific symptom without any infarction or ischemia on magnetic resonance imaging. In our MMD registry, 40 patients (74 hemispheres) were identified and enrolled in this retrospective cohort study. Their demographic, radiological and clinical findings were evaluated. The log-rank test was used to assess prognostic factors. Pearson's correlation test and the Mann-Whitney U test were used to identify correlation angiographic staging and age or perfusion status. Results: Overall, 6 patients underwent indirect bypass surgery and 36 received antiplatelet medication. On initial single positron emission tomography (35 patients, 67 affected hemispheres), basal and acetazolamide stress brain perfusion were decreased in 19 (28.4%) and 22 (32.8%) hemispheres, respectively. Among 70 angiographically evaluated hemispheres, 6 were unilateral MMD; 27 of 64 affected hemispheres (42.2%) had transdural collateral at evaluation. Age (p = 0.309, Pearson's correlation test) and hemodynamic impairment (p = 0.614, Mann-Whitney U test) did not correlate with angiographic staging. During a median 32-month (range 6-203) clinical follow-up, 3 nonsurgically treated patients had a transient ischemic attack, which was associated with decreased vascular reserve (p < 0.001, log-rank test) and smoking (p = 0.017). Other variables did not show a significant association with clinical progression. During a median 24-month (range 12-108) radiological follow-up, 3 patients displayed angiographic progression and 3 displayed new hemodynamic abnormalities. Radiological progressions were related to hypertension only (p = 0.022). In this case series, there was no case of ischemic or hemorrhagic stroke. Conclusion: The findings suggest that asymptomatic MMD in adults is not a stable disease in our definition. However, stroke rate (0%) was lower than previous reports. Lifestyle modification, stroke risk factor control and/or antiplatelet medication seem to be appropriate initial treatments for patients with normal cerebrovascular reserve. A clear definition of asymptomatic MMD and further clarification of its clinical course are needed to set precise treatment guidelines.

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“…In 2012 Hansen et al [12] proposed that patients suffering from DRS could be identified based on the following criteria [3,5]:…”

Section: Introductionmentioning

confidence: 99%

Deep Brain Stimulation for the Treatment of Dejerine-Roussy Syndrome

Ward

Mammis²

2017

Stereotact Funct Neurosurg

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Background/Aims: Patients who suffer from Dejerine-Roussy syndrome commonly experience severe poststroke hemibody pain which has historically been attributed to thalamic lesions. Despite pharmacological treatment, a significant proportion of the population is resistant to traditional therapy. Deep brain stimulation is often appropriate for the treatment of resistant populations. In this review we aim to summarize the targets that are used to treat Dejerine-Roussy syndrome and provide insight into their clinical efficacy. Methods: In reviewing the literature, we defined stimulation success as achievement of a minimum of 50% pain relief. Results: Contemporary targets for deep brain stimulation are the ventral posterior medial/ventral posterior lateral thalamic nuclei, periaqueductal/periventricular gray matter, the ventral striatum/anterior limb of the internal capsule, left centromedian thalamic nuclei, the nucleus ventrocaudalis parvocellularis internis, and the posterior limb of the internal capsule. Conclusions: Due to technological advancements in deep brain stimulation, its therapeutic effects must be reevaluated. Despite a lack of controlled evidence, deep brain stimulation has been effectively used as a therapeutic in clinical pain management. Further clinical investigation is needed to definitively evaluate the therapeutic efficacy of deep brain stimulation in treating the drug-resistant patient population.

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Pain following stroke: A prospective study

Cited by 150 publications

References 26 publications

Post Stroke Pain: Identification, Assessment, and Therapy

Post Stroke Pain: Identification, Assessment, and Therapy

Clinical Course of Asymptomatic Adult Moyamoya Disease

Deep Brain Stimulation for the Treatment of Dejerine-Roussy Syndrome

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