Practice Current

Dave, Ajal; Ganesh, Aravind; Adil, Malik M; Tsao, Jack W.

doi:10.1212/cpj.0000000000000656

Cited by 3 publications

(1 citation statement)

References 42 publications

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“…There are no available guidelines for treating posttraumatic headache, and there is extraordinary variability in treatment practices as a result. A global survey of physicians treating PTH found that the three most utilized interventions included reassurance, education about lifestyle factors affecting headache, and prescription of headache preventative medication [5].…”

Section: Introductionmentioning

confidence: 99%

Methods for Factors Affecting Behavioral Treatment in Veterans with Headache Attributable to Mild to Moderate Traumatic Brain Injury

Nabity,

Houle,

Turner

et al. 2024

Preprint

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Over 400,000 U.S. military personnel have been diagnosed with a mild or moderate traumatic brain injury (TBI) since the year 2000. Posttraumatic headache (PTH) is one of the most common and bothersome sequela after a mild or moderate head injury. Persistent posttraumatic headache are headaches due to the head injury lasting longer than 3 months. About 40% of military personnel who develop PTH after a TBI have persistent PTH and about 20% have PTH lasting longer than a year after the original injury. Persistent PTH has a negative impact on daily activities, including work and social functioning.There are no available guidelines for treating posttraumatic headache, and there is extraordinary variability in treatment practices as a result. The present study aims to identify predictive factors that account for heterogeneity in response to behavioral intervention for posttraumatic headache attributable to mild to moderate TBI. We intend to create a predictive model of PTH through the adoption of the Predictive Approaches to Treatment effect Heterogeneity Statement (PATH Statement). This rigorous, guided approach will be used to develop and validate a predictive model of psychosocial factors related to PTH treatment outcomes, thereby improving individualized treatment of PTH. This protocol provides an overview of the research design and methods for this study.

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Section: Introductionmentioning

confidence: 99%

Methods for Factors Affecting Behavioral Treatment in Veterans with Headache Attributable to Mild to Moderate Traumatic Brain Injury

Nabity,

Houle,

Turner

et al. 2024

Preprint

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Persistent post-traumatic headache: a migrainous loop or not? The clinical evidence

et al. 2020

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Background: Headache is a common complication of traumatic brain injury. The International Headache Society defines post-traumatic headache as a secondary headache attributed to trauma or injury to the head that develops within seven days following trauma. Acute post-traumatic headache resolves after 3 months, but persistent posttraumatic headache usually lasts much longer and accounts for 4% of all secondary headache disorders. Main body: The clinical features of post-traumatic headache after traumatic brain injury resemble various types of primary headaches and the most frequent are migraine-like or tension-type-like phenotypes. The neuroimaging studies that have compared persistent post-traumatic headache and migraine found different structural and functional brain changes, although migraine and post-traumatic headache may be clinically similar. Therapy of various clinical phenotypes of post-traumatic headache almost entirely mirrors the therapy of the corresponding primary headache and are currently based on expert opinion rather than scientific evidence. Pharmacologic therapies include both abortive and prophylactic agents with prophylaxis targeting comorbidities, especially impaired sleep and post-traumatic disorder. There are also effective options for non-pharmacologic therapy of posttraumatic headache, including cognitive-behavioral approaches, onabotulinum toxin injections, lifestyle considerations, etc. Conclusion: Notwithstanding some phenotypic similarities, persistent post-traumatic headache after traumatic brain injury, is considered a separate phenomenon from migraine but available data is inconclusive. High-quality studies are further required to investigate the pathophysiological mechanisms of this secondary headache, in order to identify new targets for treatment and to prevent disability.

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The Differential Diagnosis and Treatment of a Patient With Concurrent Cervicogenic Headache, Concussion, and Hyperlaxity

Smolgovskiy,

Swanson

2022

JOSPT Cases

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Background Patients presenting with concurrent headache types present a challenge in diagnosis and subsequent treatment. Cervicogenic headache, concussion, and cervical artery dysfunction may present with similar and often overlapping symptoms and impairments. These include but are not limited to neck pain and headache, dysphagia, dysarthria, diplopia, dizziness, drop attacks, nystagmus, nausea, and nervousness. Case Presentation A 40-year-old female presented with a history of insidious onset left-sided neck pain, occipital headache, and subsequent concussion history. Additional symptoms included intermittent dizziness, nausea/vomiting, and intolerance of noise/computers. Cervicogenic symptoms were ruled in with upper cervical mobility tests. Vestibular symptoms were provoked with Vestibular/Ocular Motor Screening. Risk factors were carefully considered; while the patient demonstrated no increase in symptoms with vertebral artery insufficiency testing, potential vascular involvement could not be completely ruled out. Discussion This case details the clinical reasoning applied to the differential diagnosis and treatment of a complex headache presentation in the presence of conflicting symptoms. JOSPT Cases 2022;2(2):103–108. doi:10.2519/josptcases.2022.10676

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Practice Current

Cited by 3 publications

References 42 publications

Methods for Factors Affecting Behavioral Treatment in Veterans with Headache Attributable to Mild to Moderate Traumatic Brain Injury

Methods for Factors Affecting Behavioral Treatment in Veterans with Headache Attributable to Mild to Moderate Traumatic Brain Injury

Persistent post-traumatic headache: a migrainous loop or not? The clinical evidence

The Differential Diagnosis and Treatment of a Patient With Concurrent Cervicogenic Headache, Concussion, and Hyperlaxity

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