Headache after moderate and severe traumatic brain injury: a longitudinal analysis.
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.
Walker
William C
WC
Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA 23298-0661, USA. wcwalker@mail2.vcu.edu
Seel
Ronald T
RT
Curtiss
Glenn
G
Warden
Deborah L
DL
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