Research Reports - Characterization of headache after traumatic brain injury

Cephalalgia. 2012 Jun;32(8):600-6

Lucas S, Hoffman JM, Bell KR, Walker W, Dikmen S

Background: Headache is a common and persistent symptom following traumatic brain
injury (TBI). Headaches following TBI are defined primarily by their temporal
association to injury, but have no defining clinical features. To provide a
framework for treatment, primary headache symptoms were used to characterize
headache. Methods: Three hundred and seventy-eight participants were
prospectively enrolled during acute in-patient rehabilitation for TBI. Headaches
were classified into migraine/probable migraine, tension-type, or cervicogenic
headache at baseline and 3, 6, and 12 months following TBI. Results: Migraine was
the most frequent headache type occurring in up to 38% of participants who
reported headaches. Probable migraine occurred in up to 25%, tension-type
headache in up to 21%, then cervicogenic headache in up to 10%. Females were more
likely to have endorsed pre-injury migraine than males, and had migraine or
probable migraine at all time points after injury. Those classified with migraine
were more likely to have frequent headaches. Conclusions: Our data show that most
headache after TBI may be classified using primary headache criteria. Migraine/probable migraine described the majority of headache after TBI across one year post-injury. Using symptom-based criteria for headache following TBI can serve as a framework from which to provide evidence-based treatment for these frequent, severe, and persistent headaches.

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