Conflict of Interest: None.
Post-Traumatic Headaches in Civilians and Military Personnel: A Comparative, Clinical Review
Article first published online: 30 MAY 2013
© 2013 American Headache Society
Headache: The Journal of Head and Face Pain
Volume 53, Issue 6, pages 881–900, June 2013
How to Cite
Theeler, B., Lucas, S., Riechers, R. G. and Ruff, R. L. (2013), Post-Traumatic Headaches in Civilians and Military Personnel: A Comparative, Clinical Review. Headache: The Journal of Head and Face Pain, 53: 881–900. doi: 10.1111/head.12123
Disclaimer: The authors have nothing to disclose. The views expressed are those of the author(s) and do not reflect the official policy of Walter Reed National Military Medical Center, the Department of the Army, the Department of Defense, the Department of Veterans Affairs, or the US Government.
- Issue published online: 30 MAY 2013
- Article first published online: 30 MAY 2013
- Manuscript Accepted: 16 MAR 2013
- Rehabilitation Research and Development Service of the Office of Research and Development of the Department of Veterans Affairs of the United States
- Wadsworth Foundation
- traumatic brain injury;
- post-traumatic stress disorder;
- post-traumatic headache
Post-traumatic headache (PTH) is the most frequent symptom after traumatic brain injury (TBI). We review the epidemiology and characterization of PTH in military and civilian settings. PTH appears to be more likely to develop following mild TBI (concussion) compared with moderate or severe TBI. PTH often clinically resembles primary headache disorders, usually migraine. For migraine-like PTH, individuals who had the most severe headache pain had the highest headache frequencies. Based on studies to date in both civilian and military settings, we recommend changes to the current definition of PTH. Anxiety disorders such as post-traumatic stress disorder (PTSD) are frequently associated with TBI, especially in military populations and in combat settings. PTSD can complicate treatment of PTH as a comorbid condition of post-concussion syndrome. PTH should not be treated as an isolated condition. Comorbid conditions such as PTSD and sleep disturbances also need to be treated. Double-blind placebo-controlled trials in PTH population are necessary to see whether similar phenotypes in the primary headache disorders and PTH will respond similarly to treatment. Until blinded treatment trials are completed, we suggest that, when possible, PTH be treated as one would treat the primary headache disorder(s) that the PTH most closely resembles.