title: Headache after moderate and severe traumatic brain injury: a longitudinal analysis.
abstract: OBJECTIVE
  To measure longitudinally headache (HA) after moderate and severe traumatic brain injury (TBI) and to examine potential association with demographic, injury, and psychologic factors.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Four Veterans Administration rehabilitation facilities (Minneapolis, Palo Alto, Richmond, Tampa) within the Defense and Veterans Brain Injury Center.
  
  
  METHODS
  Consecutive patients (military or veteran beneficiaries) with moderate or severe TBI (N=109) who during acute rehabilitation consented to data collection and who completed 6- and 12-month follow-up evaluations.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  HA frequency, location, type, and incapacitation levels measured during prospective neurologic assessments.
  
  
  RESULTS
  Nearly 38% (41/109) of patients had acute posttraumatic headache (PTHA) symptoms; most often in a frontal location (20/41), most often of daily frequency (31/41), and showing no relation to injury severity, emotional, or demographic variables. Postacutely, PTHA symptom severity declined within the group. Better individual improvement was associated with less anxiety and depression at 6-month follow-up. Almost all subjects (21/22) with PTHA symptoms that persisted into the 6-month follow-up period reported symptoms again at 12-month follow-up.
  
  
  CONCLUSIONS
  PTHA severity in this sample of persons with moderate and severe TBI showed a pattern of improvement that leveled off by 6 months posthospitalization.
authors.affiliation: Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA 23298-0661, USA. wcwalker@mail2.vcu.edu
authors.forename: William C
authors.initials: WC
authors.lastname: Walker
authors.forename: Ronald T
authors.initials: RT
authors.lastname: Seel
authors.forename: Glenn
authors.initials: G
authors.lastname: Curtiss
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Warden
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis* / Q000534:rehabilitation* / Q000628:therapy; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006261:Headache / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D006787:Hospitals, Veterans; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011336:Probability; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D016896:Treatment Outcome