Research Reports - Natural history of headache five years after traumatic brain injury
J Neurotrauma. 2017 Jan 18. doi: 10.1089/neu.2016.4721. [Epub ahead of print]
Stacey A(1), Lucas S(1,)(2,)(3), Dikmen S(1,)(3,)(4), Temkin N(1,)(3,)(5), Bell
KR(6), Brown A(7), Brunner R(8), Diaz-Arrastia R(9), Watanabe TK(10), Weintraub
A(11), Hoffman JM(1).
Headache is one of the most frequently reported symptoms following traumatic
brain injury (TBI). Little is known about how these headaches change over time.
We describe the natural history of headache in individuals with moderate to
severe TBI over 5 years after injury. A total of 316 patients were prospectively
enrolled and followed at 3, 6, 12, and 60 months after injury. Individuals were
72% male, 73% white, and 55% injured in motor vehicle crashes, with an average
age of 42. Pre-injury headache was reported in 17% of individuals. New or worse
headache prevalence remained consistent with at least 33% at all time points.
Incidence was >17% at all time points with first report of new or worse headache
in 20% of participants at 60 months. Disability related to headache was high,
with average headache pain (on 0-10 scale) ranging from 5.5 at baseline to 5.7 at
60 months post-injury, and reports of substantial impact on daily life across all
time points. More than half of classifiable headaches matched the profile of
migraine or probable migraine. Headache is a substantial problem after TBI.
Results suggest that ongoing assessment and treatment of headache after TBI is
needed, as this symptom may be a problem up to 5 years post-injury.