Pain Syndromes Associated With Cerebrovascular Accidents

Mary Keszler, Tulasi Gude, Kimberly Heckert

Research output: Chapter in Book/Report/Conference proceedingChapter


Pain after a cerebrovascular event can be extremely debilitating, affecting thousands of patients every year, as cerebrovascular events are one of the most common causes of morbidity and mortality in the United States. The four most common painful conditions in this population are central poststroke pain, shoulder hand syndrome, poststroke headache, and hemiplegic shoulder pain, with reported incidence rates ranging from 1.5% to 70%. Investigation to elucidate the pathophysiology of these conditions has concluded that central poststroke pain is a central neuropathic syndrome and shoulder hand syndrome is a form of complex regional pain syndrome; however, the etiologies of poststroke headache and hemiplegic shoulder pain are still unclear. Although some diagnostic tests may be helpful, the diagnosis for all four conditions is primarily based on the patient's reported history as well as the physical examination. Similar to other neuropathic pain syndromes, there is no single treatment option for patients with these conditions, and multiple factors must be considered in the development of the care plan for adequate symptom management and improved function.

Original languageEnglish (US)
Title of host publicationChallenging Neuropathic Pain Syndromes
Subtitle of host publicationEvaluation and Evidence-Based Treatment
PublisherElsevier Inc.
Number of pages11
ISBN (Electronic)9780323496070
ISBN (Print)9780323485661
StatePublished - 2018
Externally publishedYes


  • Allodynia
  • Anticonvulsants
  • Antidepressants
  • Central poststroke pain
  • Cerebrovascular event
  • Hemiplegic shoulder pain
  • Modalities
  • Neuropathic pain
  • Poststroke headache
  • Shoulder hand syndrome
  • Stroke

ASJC Scopus subject areas

  • Medicine(all)


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