Post-traumatic Headaches after Traumatic Brain Injury in a Military and Veteran Cohort

Research Objectives: To examine post-traumatic headaches (PTH) characteristics in subjects with post-TBI.

Design: Cohort analysis of TBI patients participating in a prospective longitudinal study to examine TBI outcomes. Descriptive statistics used to describe the headache characteristics of the participants.

Setting: VA Palo Alto Polytrauma Rehabilitation Center.

Participants: 224 U.S Military Service Members and Veterans diagnosed with mild-severe TBI, seen for rehabilitation/treatment and followed at Years: 1, 2, and 5 post-injury.

Interventions: Not applicable.

Main Outcome Measures: Patterns and trajectory of PTHs.

Results: 39% of the injuries were Blast-related, following 22% motor vehicular accidents. Most participants reported having headaches at the time of rehabilitation and treatment (61%). Among those with mild TBI 75% reported experiencing headaches post-TBI. The percentage of participants that reported experiencing 15 or more headache episodes per month, was 48% of those with mild-TBI. The majority of the severe TBI 49%, and mild-TBI 35% participants reported an episodic pattern of headaches, lasting between 4 hrs to 24 hrs, untreated headaches during the first year. Unilateral headache episodes among the mild TBI were reported with some headaches, 35%, and among severe TBI with every headache, 34%. In describing the level of headache pain, 37% of mild TBI participants reported feeling throbbing or pulsating sensation when it is at its worst, and 33% of the severe TBI participants reported feeling pressure or “vise-like’ headache sensation.

Conclusions: Post-traumatic headaches are a common sequelae post-injury, and are often a difficult post-concussive symptom for patients to manage. This analysis serves as a foundation for understanding PTHs and for informing advances in treatment.

Author(s) Disclosures: I have no financial interests or relationships to disclose.