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September 23, 2014; 83 (13) Article

Central poststroke pain in young ischemic stroke survivors in the Helsinki Young Stroke Registry

Hanna Harno, Elena Haapaniemi, Jukka Putaala, Maija Haanpää, Jyrki P. Mäkelä, Eija Kalso, Turgut Tatlisumak
First published August 15, 2014, DOI: https://doi.org/10.1212/WNL.0000000000000818
Hanna Harno
From the Departments of Neurology (H.H., E.H., J.P., T.T.), Neurosurgery (M.H.), and Anesthesiology (E.K.), and BioMag Laboratory, HUS Medical Imaging Center (J.P.M.), Helsinki University Central Hospital; and Etera Mutual Pension Insurance Company (M.H.), Helsinki, Finland.
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Elena Haapaniemi
From the Departments of Neurology (H.H., E.H., J.P., T.T.), Neurosurgery (M.H.), and Anesthesiology (E.K.), and BioMag Laboratory, HUS Medical Imaging Center (J.P.M.), Helsinki University Central Hospital; and Etera Mutual Pension Insurance Company (M.H.), Helsinki, Finland.
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Jukka Putaala
From the Departments of Neurology (H.H., E.H., J.P., T.T.), Neurosurgery (M.H.), and Anesthesiology (E.K.), and BioMag Laboratory, HUS Medical Imaging Center (J.P.M.), Helsinki University Central Hospital; and Etera Mutual Pension Insurance Company (M.H.), Helsinki, Finland.
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Maija Haanpää
From the Departments of Neurology (H.H., E.H., J.P., T.T.), Neurosurgery (M.H.), and Anesthesiology (E.K.), and BioMag Laboratory, HUS Medical Imaging Center (J.P.M.), Helsinki University Central Hospital; and Etera Mutual Pension Insurance Company (M.H.), Helsinki, Finland.
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Jyrki P. Mäkelä
From the Departments of Neurology (H.H., E.H., J.P., T.T.), Neurosurgery (M.H.), and Anesthesiology (E.K.), and BioMag Laboratory, HUS Medical Imaging Center (J.P.M.), Helsinki University Central Hospital; and Etera Mutual Pension Insurance Company (M.H.), Helsinki, Finland.
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Eija Kalso
From the Departments of Neurology (H.H., E.H., J.P., T.T.), Neurosurgery (M.H.), and Anesthesiology (E.K.), and BioMag Laboratory, HUS Medical Imaging Center (J.P.M.), Helsinki University Central Hospital; and Etera Mutual Pension Insurance Company (M.H.), Helsinki, Finland.
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Turgut Tatlisumak
From the Departments of Neurology (H.H., E.H., J.P., T.T.), Neurosurgery (M.H.), and Anesthesiology (E.K.), and BioMag Laboratory, HUS Medical Imaging Center (J.P.M.), Helsinki University Central Hospital; and Etera Mutual Pension Insurance Company (M.H.), Helsinki, Finland.
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Central poststroke pain in young ischemic stroke survivors in the Helsinki Young Stroke Registry
Hanna Harno, Elena Haapaniemi, Jukka Putaala, Maija Haanpää, Jyrki P. Mäkelä, Eija Kalso, Turgut Tatlisumak
Neurology Sep 2014, 83 (13) 1147-1154; DOI: 10.1212/WNL.0000000000000818

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Abstract

Objective: We describe the frequency, duration, clinical characteristics, and radiologic correlates of central poststroke pain (CPSP) in young ischemic stroke survivors in a prospective study setting.

Methods: A questionnaire of pain and sensory abnormalities and EQ-5D quality-of-life questionnaire were sent to all 824 surviving and eligible patients of the Helsinki Young Stroke Registry. Patients (n = 58) with suspected CPSP were invited to a clinical visit and filled in the PainDETECT, Brief Pain Inventory, and Beck Depression Inventory questionnaires.

Results: Of the included 824 patients, 49 had CPSP (5.9%), 246 patients (29.9%) had sensory abnormality without CPSP, and 529 patients (64.2%) had neither sensory abnormality nor CPSP. The median follow-up time from stroke was 8.5 years (interquartile range 5.0–12.1). Patients with CPSP had low quality of life compared to those with sensory abnormality without CPSP (p = 0.007) as well as to those with no sensory abnormality and no CPSP (p < 0.001). Forty (82%) of the patients with CPSP had concomitant other pain. CPSP was associated with moderate (p < 0.001) and severe (p < 0.001) stroke symptoms, but there was no difference in age at stroke onset or subtype of stroke according to the TOAST classification between the groups. Stroke localization was not correlated with CPSP.

Conclusions: Late persistent CPSP was found in 5.9% of young stroke survivors and was associated with concomitant other pain, impaired quality of life, and moderate or severe stroke symptoms.

GLOSSARY

ADL=
activities of daily living;
BPI=
Brief Pain Inventory;
CPSP=
central poststroke pain;
MCA=
middle cerebral artery;
NIHSS=
NIH Stroke Scale;
PCA=
posterior cerebral artery;
TOAST=
Trial of Org 10172 in Acute Stroke Treatment

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Received January 20, 2014.
  • Accepted in final form June 27, 2014.
  • © 2014 American Academy of Neurology
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