Disclaimers: Part of the materials found in this manuscript was presented as a poster at the American Headache Society 52nd annual meeting, June 24-27, 2010.
Prevalence and Treatment of Headaches in Veterans With Mild Traumatic Brain Injury
Version of Record online: 18 JUL 2011
© 2011 American Headache Society
Headache: The Journal of Head and Face Pain
Volume 51, Issue 7, pages 1112–1121, July/August 2011
How to Cite
Patil, V. K., St. Andre, J. R., Crisan, E., Smith, B. M., Evans, C. T., Steiner, M. L. and Pape, T. L. (2011), Prevalence and Treatment of Headaches in Veterans With Mild Traumatic Brain Injury. Headache: The Journal of Head and Face Pain, 51: 1112–1121. doi: 10.1111/j.1526-4610.2011.01946.x
Funding: This study was supported by the Department of Veterans Affairs, Office of Research and Development, Health Services Research and Development Service as grant IIR 07-188-3, Locally-Initiated Project 42-533 and the Edward Hines Jr. VA Hospital, Center for Management of Complex Chronic Care (CMC3). The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.
Reprints will not be available from the authors.
Author Financial Disclosure and Conflicts of Interest: We certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are associated AND, if applicable, we certify that all financial and material support for this research (eg, NIH or NHS grants) and work are clearly identified in the title page of the manuscript.
- Issue online: 18 JUL 2011
- Version of Record online: 18 JUL 2011
- Accepted for publication April 19, 2011.
- brain injury;
- blast injury
Objectives.— To report the prevalence and characteristics of headaches in veterans with mild traumatic brain injury (TBI) and to describe most common treatment strategies after neurological evaluation.
Methods.— We conducted a retrospective cohort study. The setting was a United States Veterans Healthcare Administration Polytrauma Network Site. The study participants consisted of 246 veterans with confirmed diagnosis of mild TBI. The main outcome measures were: Self-reported head pain occurring 30 days prior to initial mild TBI screening; headache severity measured by the Neurobehavioral Symptom Inventory; headache characteristics; and treatment prescribed by neurologists.
Results.— The majority (74%) of veterans with a confirmed diagnosis of mild TBI (N = 246), due largely to blast exposure, reported headaches in the 30 days preceding the initial mild TBI evaluation. Thirty-three percent of these veterans (N = 81) were referred to neurology for persistent headaches. Of the 56 veterans attending the neurology evaluation, 45% were diagnosed with migraine headaches and 20% with chronic daily headaches. The most commonly used abortive agents were triptans (68%) and the most common preventive medications were anticonvulsants (55%) and tricyclics (40%).
Conclusion.— There was an increased prevalence of headaches in veterans with mild TBI. Most of the TBI veterans in our study group were exposed to blast injury and findings indicate that the nature of head trauma may be contributing to headaches. Findings highlight the need for developing effective headache prevention and treatment strategies for all persons with mild TBI and in particular for veterans with blast-related mild TBI.