Post-traumatic headache attributed to traumatic brain injury: classification, clinical characteristics, and treatment

Ashina, Håkan; Eigenbrodt, Anna K.; Seifert, Tad; Sinclair, Alexandra J; Scher, Ann I.; Schytz, Henrik Winther; Lee, Mi Ji; Icco, Roberto De; Finkel, Alan G.; Ashina, Messoud

doi:10.1016/s1474-4422(21)00094-6

Cited by 80 publications

(85 citation statements)

References 72 publications

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“…Moderate headache intensity = impairs but does not prevent ability to work and/or other activities. Severe headache intensity = prevents ability to work and/or other activities b positive family history of primary headache disorders = 1st degree relative with any primary headache disorder other than infrequent tension-type headache c continuous photophobia = continuously ongoing – daily – symptoms of photophobia d continuous phonophobia = continuously ongoing – daily – symptoms of phonophobia e cutaneous allodynia scores were assessed using the 12-item Allodynia Symptom Checklist (ASC-12) and defined as follows: none (scores 0–2), mild [ 3 – 5 ], moderate [ 6 – 8 ], and severe (≥9)…”

Section: Resultsmentioning

confidence: 99%

“…e cutaneous allodynia scores were assessed using the 12-item Allodynia Symptom Checklist (ASC-12) and defined as follows: none (scores 0–2), mild [ 3 – 5 ], moderate [ 6 – 8 ], and severe (≥9)…”

Section: Resultsmentioning

confidence: 99%

“…Headache is a common sequela of mild traumatic brain injury (TBI), [1][2][3], as well as a frequent cause of chronic daily headache in the general population [4]. Few efforts have been made to assess the broader clinical picture of post-traumatic headache (PTH), [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Psychiatric and cognitive comorbidities of persistent post-traumatic headache attributed to mild traumatic brain injury

et al. 2021

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Objective To investigate the association of psychiatric and cognitive comorbidities with persistent post-traumatic headache (PTH) attributed to mild traumatic brain injury (TBI). Methods A total of 100 patients with persistent PTH attributed to mild TBI and 100 age- and gender-matched healthy controls free of mild TBI were enrolled between July 2018 and June 2019. Quality of sleep was evaluated using the Pittsburgh Sleep Quality Index, while symptoms of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Cognitive impairment was evaluated using the Montreal Cognitive Assessment questionnaire, while post-traumatic stress disorder (PTSD) was assessed using the Harvard Trauma Questionnaire. Results In 100 patients with persistent PTH, 85% reported poor quality sleep, compared with 42% of healthy controls (P < 0.01). The relative frequency of probable to high risk of anxiety was 52% in the persistent PTH group vs. 8% in healthy controls (P < 0.01), while the relative frequency of probable to high risk of depression was 42% in the persistent PTH group vs. 2% in healthy controls (P < 0.01). Furthermore, 27% of the patients with persistent PTH had mild cognitive impairment while 10% had probable PTSD. Conclusions Poor quality of sleep as well as symptoms suggestive of anxiety and depression were more common in patients with persistent PTH than healthy controls. Clinicians should screen patients with persistent PTH for these comorbidities and develop treatment plans that account for their presence.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Psychiatric and cognitive comorbidities of persistent post-traumatic headache attributed to mild traumatic brain injury

et al. 2021

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“…The most common patient and disease-related barriers were connected to diagnosis and treatment (Table 2 ). An unclear medical history is reported by more than half of residents as an impediment, which may also overlap with comorbidities also being reported as a common barrier [ 2 , 4 , 25 ]. This is troubling as diagnosis of headache disorders rely on the medical history.…”

Section: Discussionmentioning

confidence: 99%

Barriers and gaps in headache education: a national cross-sectional survey of neurology residents in Denmark

et al. 2022

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Background A major barrier to adequate headache care is the relative lack of formal education and training of healthcare professionals. Concerted efforts should be made to pinpoint major gaps in knowledge in healthcare professionals to facilitate better educational policies in headache training. The aim of this study was to identify deficiencies and barriers in headache training among residents in neurology in Denmark. Methods We conducted a national cross-sectional survey of residents in neurology in Denmark from April 2019 to September 2019. The survey included questions on participant demographics, knowledge of and barriers in headache disorders, guidelines and diagnostic tools usage, contact with primary and tertiary care, medication overuse, and non-pharmacological interventions. Furthermore, respondents were asked to provide a ranked list from most to least interesting for six sub-specializations/disorders, i.e., cerebrovascular disease, dementia, epilepsy, headache, multiple sclerosis, Parkinson's disease. Results Sixty (40%) out of estimated a population of ~ 150 resident across Denmark accepted the invitation. Of these, 54/60 (90%) completed the survey. Although two-thirds, 35/54 (65%), of the respondents had prior formalized training in headache disorders, we identified gaps in all explored domains including diagnosis, management, and referral patterns. Particularly, there was an inconsistent use of guidelines and diagnostic criteria from the Danish Headache Society (2.74 (± 1.14)), the Danish Neurological Society (3.15 (± 0.86)), and the International Classification of Headache Disorders (2.33 (± 1.08)); 1: never/have not heard of, 4: always. Headache was ranked second to last out of six sub-specializations in interest. Conclusions Overall knowledge on headache disorders amongst neurology residents in Denmark do not meet the expectations set out by national and international recommendations. Stakeholders should make strategic initiatives for structured education in headache for improved clinical outcomes in parallel with costs reduction through resource optimization.

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“…Post-traumatic headache (PTH) is defined as headache developing within seven days after precedent trauma or regaining consciousness from traumatic consciousness loss [1]. Moreover, it is commonly caused by traumatic brain injury (TBI) and is characterized by migraine or tension-type headaches [2]. The incidences of PTH in patients with moderate/severe and mild TBI are 71% and 54%, respectively [3].…”

Section: Introductionmentioning

confidence: 99%

Associations between Zygoma Fracture and Post-Traumatic Headache: A Study among Taiwanese Population

Hsiao

Hsu

Lin

et al. 2021

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Few studies have discussed the development of post-traumatic headache (PTH) after zygoma fracture. This research aimed to examine the association between zygoma fracture and PTH and its other associated factors. A total of 3043 patients with zygoma fracture and 3043 patients with non-fracture were included in this analysis. They were matched to a non-fracture cohort from the National Health Insurance database according to age, sex, and index year. The incidence of PTH and its association with zygoma fracture were assessed. The zygoma fracture cohort had a significantly higher cumulative incidence of PTH than the non-fracture cohort in a 10-year follow-up. The confounding risk factors of PTH included zygoma fracture, female sex, and comorbidities, including obesity and depression. Female patients under 40 years old who had zygoma fractures had a higher incidence of PTH than the non-fracture group. Moreover, patients with zygoma fractures commonly developed PTH within three months after injury. Female patients under 40 years old with precedent zygoma fractures had a higher incidence rate of PTH than those without fractures. Moreover, patients with zygoma fractures commonly developed PTH within three months after injury. Nevertheless, before widely applying our results, a prospective study must be conducted to verify the risk factors found in this study.

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Post-traumatic headache attributed to traumatic brain injury: classification, clinical characteristics, and treatment

Cited by 80 publications

References 72 publications

Psychiatric and cognitive comorbidities of persistent post-traumatic headache attributed to mild traumatic brain injury

Psychiatric and cognitive comorbidities of persistent post-traumatic headache attributed to mild traumatic brain injury

Barriers and gaps in headache education: a national cross-sectional survey of neurology residents in Denmark

Associations between Zygoma Fracture and Post-Traumatic Headache: A Study among Taiwanese Population

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