Research Reports - Chronic post-traumatic headache after mild head injury

Cephalalgia. 2013 Sep 17

Kjeldgaard D, Forchhammer H, Teasdale T, Jensen RH

BACKGROUND: The aetiology behind chronic post-traumatic headache (CPTH) after
mild head injury is unclear and management is complicated. In order to optimize
treatment strategies we aimed to characterize a CPTH population.
METHODS: Ninety patients with CPTH and 45 patients with chronic primary headaches
were enrolled from the Danish Headache Center. All patients were interviewed
about demographic and headache data. They completed the Harvard Trauma
Questionnaire (HTQ), Rivermead Post Concussion Symptoms Questionnaire, SF-36 and
a headache diary.
RESULTS: The CPTH group experienced more cognitive ( P < 0.001) and somatic
symptoms ( P = 0.048) and rated their self-perceived health as more affected in
terms of physical function ( P = 0.036), physical role function ( P = 0.012) and
social function ( P = 0.012) than the control group. Surprisingly, 31% of the
CPTH group had a score equal to or above the cut-off score for having
post-traumatic stress disorder (PTSD) according to the HTQ. In terms of
demographics and headache, the groups were comparable except the CPTH group were
more often without affiliation to the labour market ( P < 0.001).
CONCLUSIONS: The loss of work capacity and high levels of disability for the CPTH
patients suggests directions for further research into what important factors are
embedded in the patients' PTSD symptoms and might explain their prolonged

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