TY - JOUR
T1 - A prospective study of prevalence and characterization of headache following mild traumatic brain injury
AU - Lucas, Sylvia
AU - Hoffman, Jeanne M.
AU - Bell, Kathleen R.
AU - Dikmen, Sureyya
N1 - Funding Information:
Dr Hoffman and Dr Bell receive research funding from NIDRR and Department of Defense.
Funding Information:
Dr Lucas receives funding from the National Institute on Disability and Rehabilitation Research (NIDRR), Department of Defense, the Wadsworth Foundation, St. Jude Medical Inc and Biogen Idec. She has received consulting fees or honoraria from Zogenix, MAP, Allergan, Biogen Idec, Genzyme, and Novartis.
Funding Information:
This study was funded by the Department of Education, National Institute on Disability and Rehabilitation Research, grant number H133G090022.
Funding Information:
Dr Dikmen receives research funding from NIDRR, Department of Defense and National Institutes of Health (NIH).
PY - 2014/2
Y1 - 2014/2
N2 - Background: Headache is one of the most common and persistent symptoms following traumatic brain injury (TBI). The current study examines the prevalence and characteristics of headache following mild TBI (mTBI). Methods: We prospectively enrolled 212 subjects within one week of mTBI who were hospitalized for observation or other system injuries in a single level 1 US trauma center and followed by telephone at three, six, and 12 months after injury for evaluation of headache. Headaches were classified according to ICHD-2 criteria as migraine, probable migraine, tension-type, cervicogenic, or unclassifiable headache. Results: Subjects were 76% male and 75% white, and 58% were injured in vehicle-related crashes. A follow-up rate of 90% (190/212) occurred at 12 months post-injury. Eighteen percent (38/212) of subjects reported having a problem with headaches pre-injury while 54% (114/210) of subjects reported new or worse headaches compared to pre-injury immediately after injury, 62% (126/203) at three months, 69% (139/201) at six months, and 58% (109/189) at one year. Cumulative incidence was 91% (172/189) over one year. Up to 49% of headaches met criteria for migraine and probable migraine, followed by tension-type headaches (up to 40%). Age (≤ 60) was found to be a risk factor, but no significant difference was found in persistence of new or worse headache compared to pre-injury between males and females. More than one-third of the subjects reported persistent headache across all three follow-up time periods. Conclusions: Headache after mTBI is very common and persistent across the first year after injury. Assertive, early treatment may be warranted to avoid chronicity and disability. Further research is needed to determine whether post-traumatic headache (PTH) responds to headache treatment used in the primary headache disorders and whether chronic PTH is preventable.
AB - Background: Headache is one of the most common and persistent symptoms following traumatic brain injury (TBI). The current study examines the prevalence and characteristics of headache following mild TBI (mTBI). Methods: We prospectively enrolled 212 subjects within one week of mTBI who were hospitalized for observation or other system injuries in a single level 1 US trauma center and followed by telephone at three, six, and 12 months after injury for evaluation of headache. Headaches were classified according to ICHD-2 criteria as migraine, probable migraine, tension-type, cervicogenic, or unclassifiable headache. Results: Subjects were 76% male and 75% white, and 58% were injured in vehicle-related crashes. A follow-up rate of 90% (190/212) occurred at 12 months post-injury. Eighteen percent (38/212) of subjects reported having a problem with headaches pre-injury while 54% (114/210) of subjects reported new or worse headaches compared to pre-injury immediately after injury, 62% (126/203) at three months, 69% (139/201) at six months, and 58% (109/189) at one year. Cumulative incidence was 91% (172/189) over one year. Up to 49% of headaches met criteria for migraine and probable migraine, followed by tension-type headaches (up to 40%). Age (≤ 60) was found to be a risk factor, but no significant difference was found in persistence of new or worse headache compared to pre-injury between males and females. More than one-third of the subjects reported persistent headache across all three follow-up time periods. Conclusions: Headache after mTBI is very common and persistent across the first year after injury. Assertive, early treatment may be warranted to avoid chronicity and disability. Further research is needed to determine whether post-traumatic headache (PTH) responds to headache treatment used in the primary headache disorders and whether chronic PTH is preventable.
KW - Posttraumatic headache (PTH)
KW - cervicogenic headache
KW - headache
KW - migraine
KW - mild traumatic brain injury
KW - probable migraine
KW - secondary headache
KW - tension-type headache
KW - traumatic brain injury (TBI)
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UR - http://www.scopus.com/inward/citedby.url?scp=84892149224&partnerID=8YFLogxK
U2 - 10.1177/0333102413499645
DO - 10.1177/0333102413499645
M3 - Article
C2 - 23921798
AN - SCOPUS:84892149224
SN - 0333-1024
VL - 34
SP - 93
EP - 102
JO - Cephalalgia
JF - Cephalalgia
IS - 2
ER -