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Semin Neurol 2018; 38(06): 619-626
DOI: 10.1055/s-0038-1673692
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Posttraumatic Headache

Brigid Dwyer
1   Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
2   Brain Injury Program, HealthSouth Braintree Rehabilitation Hospital, Braintree, Massachusetts
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Publication History

Publication Date:
06 December 2018 (online)

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Abstract

Posttraumatic headaches are among the most challenging complaints after mild traumatic brain injury (mTBI). They are a debilitating problem experienced by patients after TBI of all severities. Up to 90% of mild TBI patients experience headache, particularly if female and with a premorbid history of primary headache. Tension headache has classically been the most common subtype, but in military populations migraine has dominated. Posttraumatic headache encompasses a spectrum of headache types that overlap heavily with common primary headache disorders, but also autonomic cephalgias as well as several secondary headache conditions. It is important to understand the evolution of postconcussion syndrome as a concept, and the challenges associated with diagnosing and treating multidomain drivers effectively. The first-line treatments for posttraumatic headache are typically the same as those used in nontraumatic headache, with additional considerations for cognitive side effects, posttraumatic epilepsy, and coexisting injuries resulting in neuropathic pain or medication overuse.

Keywords

Posttraumatic Headache - concussive headache - postconcussion syndrome - posttraumatic disorder