Prof. Dr. med. Christoph Schankin

Stroke vs. stroke-mimics: differentiating the acute neurological deficit

In the emergency setting, patients with acute neurological deficits may have vascular etiology, i.e. ischemic or hemorrhagic strokes, or stroke-mimics. An important differential diagnosis to stroke is acute migraine aura. This differentiation is investigated in the HoGaN-study (“How Good are Neurologists?”) that assesses the ability of neurologists to correctly identify stroke, stroke mimics, stroke mechanism (i.e. ischemic vs. hemorrhagic) as well as lesion location based on clinical grounds. Further, we investigate the “index vein” found in acute imaging during or shortly after acute migraine aura to improve our understanding of cortical spreading depression. In the RIVEAN-study (“Evaluating the Relevance of the Index Vein sign for differentiating the Etiology of an Acute Neurological deficit”), we assess whether the “index vein” is able to distinguish between migraine aura and the important differential diagnoses, stroke and epileptic seizures. We also compare the clinical presentation of patients with stroke to patients with migraine aura to understand what distinguishes the individual episodes. This is important in clinical practice, since it challenges the theoretical concept of vascular events being acute negative phenomena whereas migraine aura should evolve slowly, i.e. over more than 5 minutes, and consist of positive phenomena.

Stroke risk of migraine

Migraineurs have increased risk of stroke. In this project, we specifically investigate if this increased risk might be mediated by an association of migraine with atrial fibrillation.

Red Flags of acute Headache (Headache in the Emergency Department: HeED-study)

This study investigates the predictive value of red flags of acute headache attacks at the emergency department. This is important since red flags are used in daily clinical routine to decide for or against additional investigation of headache patients although the predictive value so far has never been sufficiently demonstrated.

Research fields:

• Headache and stroke