Post-traumatic headache in patients with minimal traumatic intracranial hemorrhage after traumatic brain injury: a retrospective matched case-control study

Hong, Chang-Ki; Shim, Yu Shik; Sim, Sook Young; Joo, Jin Yang; Kwon, Min Soo; Kim, Yong Bae; Chung, Joonho

doi:10.1186/s10194-017-0774-6

Cited by 6 publications

(5 citation statements)

References 23 publications

(23 reference statements)

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“…In both cases, the presence of PTSD may play a relevant role in disability and psychosocial impairment related to PPTH. The current literature upon this topic is growing rapidly, showing a spreading interest in this area in terms of diagnostic tool applications, differential diagnosis among headaches, and epidemiological data from emergency and psychiatric departments, which are the ideal frame for unbiased studies on these patients, in order to have more valid data in the future that will help us understand if this research path is worth pursuing [65][66][67][68][69][70][71]. Importantly, we have also to carefully address the link between emotional turmoil, which is closely linked to suicidal behavior, in PTH patients.…”

Section: Discussionmentioning

confidence: 99%

The Relation between Persistent Post-Traumatic Headache and PTSD: Similarities and Possible Differences

Guglielmetti

Serafini

Amore

et al. 2020

IJERPH

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Post-traumatic headache (PTH) may be considered a secondary headache, which is linked to severe disability and psychosocial impairment. Interestingly, nearly 30% of subjects with persistent post-traumatic headache (PPTH) also suffer from post-traumatic stress disorder (PTSD). Although existing studies demonstrated the existence of common pathophysiological characteristics in subjects with migraine and PPTH, the differences and similarities between these complex diseases are currently poorly understood and are yet to be comprehensively elucidated. Thus, the present review aimed to systematically investigate the nature of PPTH in the effort to better identify both the neurobiological and clinical aspects underlying this condition. Overall, the included studies reported that: (1) the predictors for persistent acute traumatic injury to the head were female gender, persistent symptoms related to mild post-traumatic brain injury (mTBI), PTSD, elevated inflammatory markers, prior mild traumatic brain injury, being injured while suffering from alcohol abuse; (2) static/dynamic functional connectivity differences, white matter tract abnormalities, and morphology changes were found between PPTH and migraine in brain regions involved in pain processing; and (3) clinical differences which were most prominent at early time points when they were linked to the increased risk of PPTH. Based on the selected reports, the relation between migraine and PPTH needs to be considered bidirectionally, but PTSD may play a critical role in this relation. The main implications of these findings, with a specific focus on PTSD, are discussed. Further longitudinal studies are needed to reveal the exact nature of this relation, as well as to clarify the distinct clinical characteristics of migraine, PPTH, and PTSD.

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Section: Discussionmentioning

confidence: 99%

The Relation between Persistent Post-Traumatic Headache and PTSD: Similarities and Possible Differences

Guglielmetti

Serafini

Amore

et al. 2020

IJERPH

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show abstract

“…However, in a recent study from Korea, the authors found that HAIH occurred more frequently 12 months post-injury in patients with minimal traumatic intracranial hemorrhage after MTBI than in those without. 29 Research on imaging findings as a predictor for headache is scarce, but some studies have investigated imaging findings as a predictor for post-concussive symptoms (PCS), a cluster of post-traumatic symptoms, including headache. A prospective study from Finland found no significant differences in the rates of PCS 1 month and 1 year following MTBI, in participants with or without MRI abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Change in Headache Suffering and Predictors of Headache after Mild Traumatic Brain Injury: A Population-Based, Controlled, Longitudinal Study with Twelve-Month Follow-Up

Nordhaug

Linde

Follestad

et al. 2019

Journal of Neurotrauma

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Headache attributed to traumatic injury to the head (HAIH) is claimed to be the most common sequela following mild traumatic brain injury (MTBI), but epidemiological evidence is scarce. We explored whether patients with MTBI had an increase in headache suffering following injury compared with controls. We also studied predictors of headache.The Trondheim MTBI follow-up study is a population-based, controlled, longitudinal study. We recruited patients exposed to MTBI and controls with minor orthopedic injuries from a trauma center and a municipal outpatient clinic, and community controls from the surrounding population. Information on headache was collected through questionnaires at baseline, and 3 and 12 months post-injury. We used a generalized linear mixed model to investigate the development of headache over time in the three groups, and logistic regression to identify predictors of headache.We included 378 patients exposed to MTBI, 82 trauma controls, and 83 community controls. The MTBI-group had a larger increase in odds of headache from baseline to the first 3 months post-injury than the controls, but not from baseline to 3–12 months post-injury. Predictors for acute HAIH were female sex and pathological imaging findings on computed tomography (CT) or magnetic resonance imaging (MRI). Predictors for persistent HAIH were prior MTBI, being injured under the influence of alcohol, and acute HAIH. Patients who experience HAIH during the first 3 months post-injury have a good chance to improve before 12 months post-injury. Female sex, imaging findings on CT or MRI, prior MTBI, and being injured under the influence of alcohol may predict exacerbation of headache.

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“…Nonetheless, this might lead to another clinical problem. Intracranial hemorrhage is associated with increased incidence of postconcussion syndrome and postconcussion headache [39,40]. Treatment is available for these patients, but if they are not identified by emergency head CT, another means of identifying them is necessary so they can be offered treatment [41,42].…”

Section: Discussionmentioning

confidence: 99%

A proposed amendment to the current guidelines for mild traumatic brain injury: reducing computerized tomographies while maintaining safety

Vedin

Karlsson

Edelhamre

et al. 2019

Eur J Trauma Emerg Surg

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Purpose Head trauma is a common complaint in emergency departments. Identifying patients with serious injuries can be difficult and generates many computerized tomographies. Reducing the number of computerized tomographies decreases both cost and radiation exposure. The aim of this study was to evaluate whether the current Scandinavian Neurotrauma Committee guidelines could be revised in such a way that would enable hospitals to perform fewer computerized tomographies while maintaining the ability to identify all patients requiring neurological intervention. Methods A retrospective study of the medical records of adult patients suffering a traumatic brain injury was performed. A total of 1671 patients over a period of 365 days were included, and 25 parameters were extracted. Multitrauma patients managed with ATLS™ were excluded. The Scandinavian Neurotrauma Committee guidelines were amended with the previously derived "low-risk proposal" and applied retrospectively to the cohort. Results Incidence of intracranial hemorrhage was 5.6% (93/1671). Application of the current Scandinavian Neurotrauma Committee guidelines would have resulted in 860 computerized tomographies and would have missed 11 intracranial hemorrhages. The proposed amendment with the low-risk proposal would have resulted in 748 CT scans and would have missed 19 intracranial hemorrhages (a relative reduction of 13%). None of the missed intracranial hemorrhages required neurological intervention. Conclusion For patients with mild and moderate traumatic brain injuries, application of the Scandinavian Neurotrauma Committee guidelines amended with the low-risk proposal may result in a significant reduction of computerized tomographies without missing any patients in need of neurological intervention.

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Post-traumatic headache in patients with minimal traumatic intracranial hemorrhage after traumatic brain injury: a retrospective matched case-control study

Cited by 6 publications

References 23 publications

The Relation between Persistent Post-Traumatic Headache and PTSD: Similarities and Possible Differences

The Relation between Persistent Post-Traumatic Headache and PTSD: Similarities and Possible Differences

Change in Headache Suffering and Predictors of Headache after Mild Traumatic Brain Injury: A Population-Based, Controlled, Longitudinal Study with Twelve-Month Follow-Up

A proposed amendment to the current guidelines for mild traumatic brain injury: reducing computerized tomographies while maintaining safety

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