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Dr. Dwaipayan Sen specializes in Stroke Medicine. Geriatric Medicine, Elderly Neurological Diseases & General Medicine. Considering the volume of questions we receive, please note questions outside above specialities will be ignored.
Headaches are common after intracranial Haemorrhage, a type of stroke where it bleeds inside the brain. These usually releive after the acute phase, usually by 2 weeks, at most by 4 weeks. The Ischaemic Stroke subtype (which happens due to a clot blocking of the blood supply) is usually not associated with headaches; probably less than 10% of such strokes are associated with headaches. Headaches as a long term complication of stroke is not uncommon. This can be just a simple headache or head feeling heavy. Usually nothing to worry and taking simple analgesics like Paracetamol helps. migrainous headaches or Post Stroke Migraine is also a common complication. the characteristics of the headache are usually that it occurs on one side of the head and is throbbing in character. Additionally weakness or sensory problems down one side mimicking a stroke may occur with the headache; often the symptoms of the old stroke may also come back. there is no timescale to these kind of delayed post stroke complications and can happen at anytime and any number of years after the stroke.
The secret of stroke prevention is really determining why it happened. Of course you need to screen for the usual culprits of Blood pressure, diabetes, High cholesterol, smoking etc. But each stroke needs thorough investigations looking at blood vessels of neck and brain, investigations related to heart and other less common genetic, metabolic and immune system related causes of stroke. Apart from good control of Blood pressure, diabetes, cholesterol, cessation of smoking, any abnormalities found in abovementioned investigations should then be taken care of with additional medicines or less commonly surgical treatment. It is therefore difficult to pinpoint one or two things to prevent another stroke. The key is investigating thoroughly to get to the bottom of why the first one happened. If you can do that and arrive at a definitive answer, you have got a good chance of preventing the second by treating or controlling that cause.