Traumatic Brain Injury, Neuroinflammation, and Post-Traumatic Headaches

Authors

  • Cynthia L. Mayer DO,

    1. VA Northwest Network Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA
    2. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
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  • Bertrand R. Huber MD, PhD,

    1. VA Northwest Network Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA
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  • Elaine Peskind MD

    1. VA Northwest Network Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA
    2. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
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  • Conflict of Interest: Drs. Mayer, Huber, and Peskind are employed by the US Department of Veterans Affairs.

Address all correspondence to C.L. Mayer, VA Puget Sound Health Care System, 1660 S. Columbian Way, S116 MIRECC, Seattle, WA, 98108, USA, email: cmayer@u.washington.edu

Abstract

Concussions following head and/or neck injury are common, and although most people with mild injuries recover uneventfully, a subset of individuals develop persistent post-concussive symptoms that often include headaches. Post-traumatic headaches vary in presentation and may progress to become chronic and in some cases debilitating. Little is known about the pathogenesis of post-traumatic headaches, although shared pathophysiology with that of the brain injury is suspected. Following primary injury to brain tissues, inflammation rapidly ensues; while this inflammatory response initially provides a defensive/reparative function, it can persist beyond its beneficial effect, potentially leading to secondary injuries because of alterations in neuronal excitability, axonal integrity, central processing, and other changes. These changes may account for the neurological symptoms often observed after traumatic brain injury, including headaches. This review considers selected aspects of the inflammatory response following traumatic brain injury, with an emphasis on the role of glial cells as mediators of maladaptive post-traumatic inflammation.

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