title: Predictors of post-traumatic headache severity among deployed military personnel.
abstract: OBJECTIVE
  The current study used a cross-sectional observational design to evaluate the relationship between psychological, physiological, and contextual factors and headache severity among 133 deployed military personnel and 4 civilian contractors diagnosed with mild traumatic brain injury (mTBI) referred to a combat support hospital in Iraq.
  
  
  BACKGROUND
  Although TBI and headache sequelae have been documented for military combatants, little is known about factors associated with headache severity.
  
  
  METHODS
  Military personnel (n = 157) and civilian (n = 4) contractors referred to a combat support hospital in Iraq underwent a standardized intake evaluation which included computerized neurocognitive testing, psychological and physical health questionnaires, a clinical interview, and a physical examination by a physician.
  
  
  RESULTS
  Results of zero-inflated Poisson regression modeling suggest that insomnia is associated with increased likelihood for endorsement of any headache, but loss of consciousness, post-traumatic stress disorder symptoms, and slowed reaction time only are predictive of headache severity. Among the subset of patients presenting to the combat support hospital within 7 days of mTBI (n = 101), number of TBI symptoms demonstrated a non-significant trend toward increased likelihood of headache endorsement of any kind, with loss of consciousness, post-traumatic stress disorder, and slowed reaction time demonstrating significant relationships with headache severity.
  
  
  CONCLUSIONS
  Knowledge of predictors of post-concussive headache onset and severity may assist clinicians in making important decisions regarding treatment recommendations for veterans with mTBI.
authors: Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
authors: Craig J
authors: CJ
authors: Bryan
authors: Ann M
authors: AM
authors: Hernandez
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006772:Hospitals, Military; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008889:Military Personnel; D051298:Post-Traumatic Headache / Q000453:epidemiology*; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D055815:Young Adult