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Can Long-Term Outcomes of Posttraumatic Headache be Predicted?

  • New and Emerging Therapies in Interventional Pain Medicine (J Hasoon, Section Editor)
  • Published:
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Abstract

Purpose of Review

Headache is one of the most common symptoms of traumatic brain injury, and it is more common in patients with mild, rather than moderate or severe, traumatic brain injury. Posttraumatic headache can be the most persistent symptom of traumatic brain injury. In this article, we review the current understanding of posttraumatic headache, summarize the current knowledge of its pathophysiology and treatment, and review the research regarding predictors of long-term outcomes.

Recent Findings

To date, posttraumatic headache has been treated based on the semiology of the primary headache disorder that it most resembles, but the pathophysiology is likely to be different, and the long-term prognosis differs as well. No models exist to predict long-term outcomes, and few studies have highlighted risk factors for the development of acute and persistent posttraumatic headaches. Further research is needed to elucidate the pathophysiology and identify specific treatments for posttraumatic headache to be able to predict long-term outcomes. In addition, the effect of managing comorbid traumatic brain injury symptoms on posttraumatic headache management should be further studied.

Summary

Posttraumatic headache can be a persistent symptom of traumatic brain injury, especially mild traumatic brain injury. It has traditionally been treated based on the semiology of the primary headache disorder it most closely resembles, but further research is needed to elucidate the pathophysiology of posttraumatic headache and determine risk factors to better predict long-term outcomes.

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Fig. 1

Adapted from Giza et al. [12•]

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Data Availability

IRB approval was not sought because this was a literature review. No patient information was reviewed for this review. The data that support the findings of this review are available from the corresponding author upon reasonable request and IRB approval, as applicable.

Abbreviations

CGRP:

Calcitonin gene-related peptide

CI:

Confidence interval

eCB:

Endocannabinoid

GCS:

Glasgow Coma Scale

mAbs:

Monoclonal antibodies

MRI:

Magnetic resonance imaging

OR:

Odds ratio

PTH:

Posttraumatic headache

TBI:

Traumatic brain injury

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Acknowledgements

We thank the staff of Neuroscience Publications at Barrow Neurological Institute for assistance with manuscript preparation.

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  1. Department of Neurology, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, 350 W Thomas Rd, Phoenix, AZ, 85013, USA

    Olivia Kingsford, Mustafa Yehya, Glynnis Zieman & Kerry L. Knievel

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  1. Olivia Kingsford
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  2. Mustafa Yehya
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  3. Glynnis Zieman
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  4. Kerry L. Knievel
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O.K. and M.Y. wrote the manuscript. O.K. prepared the figures. All authors reviewed the manuscript.

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Correspondence to Kerry L. Knievel.

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Kingsford, O., Yehya, M., Zieman, G. et al. Can Long-Term Outcomes of Posttraumatic Headache be Predicted?. Curr Pain Headache Rep (2024). https://doi.org/10.1007/s11916-024-01254-2

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