title: Natural History of Headache Five Years after Traumatic Brain Injury.
abstract: 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.
authors.affiliation: 1 Department of Rehabilitation Medicine, University of Washington Medical Center , Seattle, Washington.
authors.forename: Arthur
authors.initials: A
authors.lastname: Stacey
authors.affiliation: 1 Department of Rehabilitation Medicine, University of Washington Medical Center , Seattle, Washington.|2 Department of Neurology, University of Washington , Seattle, Washington.|3 Department of Neurological Surgery, University of Washington , Seattle, Washington.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Lucas
authors.affiliation: 1 Department of Rehabilitation Medicine, University of Washington Medical Center , Seattle, Washington.|3 Department of Neurological Surgery, University of Washington , Seattle, Washington.|4 Department of Psychiatry and Behavioral Medicine, University of Washington , Seattle, Washington.
authors.forename: Sureyya
authors.initials: S
authors.lastname: Dikmen
authors.affiliation: 1 Department of Rehabilitation Medicine, University of Washington Medical Center , Seattle, Washington.|3 Department of Neurological Surgery, University of Washington , Seattle, Washington.|5 Department of Biostatistics, University of Washington , Seattle, Washington.
authors.forename: Nancy
authors.initials: N
authors.lastname: Temkin
authors.affiliation: 6 Department of Physical Medicine and Rehabilitation, UT Southwestern , Dallas, Texas.
authors.forename: Kathleen R
authors.initials: KR
authors.lastname: Bell
authors.affiliation: 7 Department of Physical Medicine and Rehabilitation, Mayo Clinic , Rochester, Minnesota.
authors.forename: Allen
authors.initials: A
authors.lastname: Brown
authors.affiliation: 8 Department of Physical Medicine and Rehabilitation, University of Alabama Birmingham , UAB Spain Rehabilitation Center, Birmingham, Alabama.
authors.forename: Robert
authors.initials: R
authors.lastname: Brunner
authors.affiliation: 9 Department of Neurology, University of Pennsylvania , Perelman School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Ramon
authors.initials: R
authors.lastname: Diaz-Arrastia
authors.affiliation: 10 MossRehab at Elkins Park, Einstein Medical Center , Elkins Park, Pennsylvania.
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Watanabe
authors.affiliation: 11 Craig Hospital , CNS Medical Group, Englewood, Colorado.
authors.forename: Alan
authors.initials: A
authors.lastname: Weintraub
authors.affiliation: 1 Department of Rehabilitation Medicine, University of Washington Medical Center , Seattle, Washington.
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Hoffman
mesh_terms: D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000150:complications* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D051298:Post-Traumatic Headache / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology*; D015995:Prevalence
keywords: TBI; headache; post-traumatic headache; secondary headache