TY - JOUR
T1 - Post-traumatic headache due to mild traumatic brain injury
T2 - Current knowledge and future directions
AU - Schwedt, Todd J.
N1 - Publisher Copyright:
© International Headache Society 2020.
PY - 2021/4
Y1 - 2021/4
N2 - Background/objective: Post-traumatic headache is one of the most common and persistent symptoms following mild traumatic brain injury. The objective of this narrative review is to provide an update on the diagnostic criteria, clinical presentation, epidemiology, pathophysiology, and treatment of post-traumatic headache, and to identify future research priorities. Methods: This is a narrative review of the literature regarding post-traumatic headache attributed to mild traumatic brain injury. Results: Onset of post-traumatic headache within 7 days of injury is the only evidence for a causal relationship between the injury and the headache included in the diagnostic criteria. Post-traumatic headache often resolves within the first few days of onset, whereas it persists for at least 3 months in 30–50%. The majority of insights into post-traumatic headache pathophysiology come from pre-clinical animal studies and human imaging studies, which implicate structural, functional, metabolic, and neuroinflammatory mechanisms for post-traumatic headache. There is a paucity of quality evidence for how to best treat post-traumatic headache. Conclusions: Although meaningful progress has been made in the post-traumatic headache field, priorities for future research are numerous, including the optimization of diagnostic criteria, a greater understanding of post-traumatic headache pathophysiology, identifying mechanisms and predictors for post-traumatic headache persistence, and identifying safe, well-tolerated, effective therapies.
AB - Background/objective: Post-traumatic headache is one of the most common and persistent symptoms following mild traumatic brain injury. The objective of this narrative review is to provide an update on the diagnostic criteria, clinical presentation, epidemiology, pathophysiology, and treatment of post-traumatic headache, and to identify future research priorities. Methods: This is a narrative review of the literature regarding post-traumatic headache attributed to mild traumatic brain injury. Results: Onset of post-traumatic headache within 7 days of injury is the only evidence for a causal relationship between the injury and the headache included in the diagnostic criteria. Post-traumatic headache often resolves within the first few days of onset, whereas it persists for at least 3 months in 30–50%. The majority of insights into post-traumatic headache pathophysiology come from pre-clinical animal studies and human imaging studies, which implicate structural, functional, metabolic, and neuroinflammatory mechanisms for post-traumatic headache. There is a paucity of quality evidence for how to best treat post-traumatic headache. Conclusions: Although meaningful progress has been made in the post-traumatic headache field, priorities for future research are numerous, including the optimization of diagnostic criteria, a greater understanding of post-traumatic headache pathophysiology, identifying mechanisms and predictors for post-traumatic headache persistence, and identifying safe, well-tolerated, effective therapies.
KW - Traumatic brain injury
KW - concussion
KW - head injury
KW - secondary headache
KW - whiplash
UR - http://www.scopus.com/inward/record.url?scp=85096298108&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85096298108&partnerID=8YFLogxK
U2 - 10.1177/0333102420970188
DO - 10.1177/0333102420970188
M3 - Review article
C2 - 33210546
AN - SCOPUS:85096298108
SN - 0333-1024
VL - 41
SP - 464
EP - 471
JO - Cephalalgia
JF - Cephalalgia
IS - 4
ER -