Citation

Hoffman JM, Lucas S, Dikmen S, Braden CA, Brown AW, Brunner R, Diaz-Arrastia R, Walker W, Watanabe T, Bell KR. J. Neurotrauma 2011; 28(9): 1719-1725.

Affiliation

University of Washington, Rehabilitation Medicine, Box 356490, Seattle, Washington, United States, 98195-6490, 206-221-6511, 206-685-3244; jeanneh@uw.edu.

Copyright

(Copyright © 2011, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2011.1914

PMID

21732765

PMCID

PMC3172878

Abstract

Headache is one of the most common persisting symptoms after traumatic brain injury (TBI). Yet there are a paucity of prospective longitudinal studies of the incidence and prevalence of headache in a sample with a range of injury severity. We sought to describe the natural history of headache in the first year after TBI, and determine the role of prior history of headache, sex, and severity of TBI as risk factors for post traumatic headache. A cohort of 452 acute, consecutive patients admitted to inpatient rehabilitation services with TBI were enrolled during their inpatient rehabilitation from February 2008 to June 2009. Subjects were enrolled across 7 acute rehabilitation centers designated as TBI Model Systems centers. They were prospectively assessed by structured interviews prior to inpatient rehabilitation discharge and at 3, 6, and 12 months after injury. Results of this natural history study suggest that 71% of participants reported headache during the first year after injury. Prevalence of headache remained high over the first year, with more than 41% of participants reporting headache at 3, 6, and 12 months post injury. Persons with a pre-injury history of headache (P<.001) and females (P<.01) were significantly more likely to report headache. The incidence of headache had no relation to TBI severity (P=.67). Overall, headache is common in the first year after TBI, independent of the severity of injury range examined in this study. Use of International Classification of Headache Disorders criteria requiring onset of headache within one week of injury underestimates rates of post traumatic headache. Better understanding of the natural history of headache including timing, type, and risk factors should aid in the design of treatment studies to prevent or reduce the chronicity of headache and its disruptive effects on quality of life.

Language: en