Clinical Perspectives on Headache after Traumatic Brain Injury

Headache after traumatic brain injury (TBI) is frequent and persistent over the first year after injury. Providers may need to focus on different symptoms presentations depending on their patient’s TBI severity.
We evaluated headache symptoms in those with moderate-to-severe TBI compared to those with mild TBI and examined our data from two perspectives: 1) from providers who treat individuals after TBI and manage multiple post-injury symptoms including headache, and 2) from headache specialists who see individuals after TBI to manage headache.
Prospective enrollment of individuals after TBI with telephone follow up at one-year post-injury.
Enrollment from hospital then community follow up.
346 individuals with moderate-to-severe TBI were enrolled during acute inpatient rehabilitation across seven TBI Model System Centers. 189 individuals with mild TBI were enrolled within one week of injury at a single center.
None.
Headache frequency, headache type, pain intensity, headache impact test-6 item (HIT-6), and depressive symptoms measured one year after injury.
Headache prevalence is high in both TBI groups. TBI Providers are more likely to evaluate and treat headache from individuals sustaining a mild TBI vs moderate-to-severe TBI. Those with mild TBI are most likely to report tension-type headache followed by migraine-type headache. The migraine-type headache has higher impact (HIT-6) and greater pain intensity. Headache specialists may encounter those with moderate-to-severe TBI who report more frequent headache and higher average pain scores compared to those with mild TBI. The severity of TBI was unrelated to depressive symptoms one year after injury, but those with headache were significantly more likely to have higher scores.
TBI Providers vs headache specialists should be aware of differences in patient symptom presentation to their respective clinics. Ongoing assessment of headache and depression over time is important following TBI of any severity. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.