All hospitalized patients with diagnosis of acute ICI confirmed with neuroimaging studies and registered in the iReNe (i-Registro Neurovascular, iNeurovascular Registry)) and PREMECEF (First Mexican Headache Registry) databases, from January 2018 to June 2022, were included. All underwent neurovascular examination, neuroimaging studies, evaluation of etiology (TOAST), in addition to a focused history on headache characteristics. The results are presented with descriptive and comparative statistics.

A total of 1106 patients were included, of whom 157 (14%) had headache; 80 (51%) were male and the mean age was 57± 12.4 years. Headache was the initial symptom in 44 (28%) and the main complaint in 16 (10%). Previous headache was found in 8 (5%). The characteristics found included: throbbing (38%), oppressive (13%); average intensity of 7.1; holocranial, 27%, frontal, 11%; most frequent accompanying symptoms: nausea and/or vomiting in 21%, dizziness and/or vertigo in 20%. ICI etiology: atherothrombotic 40 (26%), lacunar 36 (23%), cardioembolic 15 (10%) and undetermined 37 (24%). Location of the ICI, 85 (54%) were anterior circulation and 42 (26%) posterior. No correlation was found between headache characteristics and ICI location (p=0.36).

The pathophysiology of headache in ICI remains a controversial topic. Our results provide similar information to that already reported; no correlation was found between the clinical characteristics of headache with the location of the ICI.