Prevalence and Clinical Patterns of Central Post-stroke Pain Syndrome After Acute Ischemic Stroke: A Prospective Observational Cohort Study.

BACKGROUND: Central post-stroke pain syndrome (CPSP) is a major neuropathic consequence after stroke, but the prevalence and clinical pattern are still inconsistently recorded. This study aims to investigate the prevalence, onset, and clinical presentation of CPSP after mild acute ischemic stroke. METHODS: We performed a prospective, hospital-based, observational cohort study of acute ischemic stroke patients. Development of CPSP was evaluated by clinical history, neurological examination, sensory profile, and neuroimaging correlation. Demographic variables, stroke characteristics, vascular risk factors, and functional outcome measures were analyzed. RESULTS: Of 720 acute ischemic stroke patients prospectively screened, 100 (13.9%, 95% CI 11.4-16.4%) met diagnostic criteria for CPSP and were included in the analysis. The mean age was 64.8 ± 7.1 years, and 63 (63.0%) were male. Middle cerebral artery territory lesions were most common (43.0%), followed by thalamic lesions (21.0%). Pain was contralateral to the stroke lesion in 98.0% of patients. In multivariable logistic regression, a higher NIHSS (National Institutes of Health Stroke Scale) score independently predicted poorer functional outcome (modified Rankin Scale (mRS) 2) at follow-up (OR: 2.915, 95% CI: 1.525-5.573, p = 0.001). CONCLUSION: CPSP is a clinically significant complication after acute ischemic stroke and should be actively screened during follow-up. Early recognition can improve symptom management and rehabilitation outcomes.