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Treatment Options for Posttraumatic Headache: A Current Review of the Literature

  • Concussion and Head Injury (A Kaye, Section Editor)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

We evaluate evidence-based treatments for posttraumatic headache (PTH), a secondary headache disorder resulting from traumatic brain injury (TBI), comprising nearly 4% of all symptomatic headache disorders. Utilizing recent publications, we aim to inform clinicians of current treatment methods.

Recent Findings

There is limited research on PTH treatment. A randomized controlled trial (RCT) of metoclopramide with diphenhydramine for acute PTH found that the treatment group (N = 81) experienced more significant pain improvement than placebo by 1.4 points. For persistent PTH, an open-label study of erenumab (N = 89) found that 28% of participants reported ≥ 50% reduction in moderate-to-severe headache days, but an RCT of fremanezumab showed a non-significant reduction in moderate-to-severe headache days. A randomized crossover study of 40 patients with persistent PTH found that onabotulinum toxin-A decreased cumulative number of headaches/week by 43.3% in the treatment group and increased by 35.1% among placebos. In a study of military veterans with severe posttraumatic stress disorder and persistent/delayed onset PTH (N = 193), patients who received Cognitive Behavioral Therapy reported significant improvements in headache-related disability compared to usual care (aggregate mean HIT-6, -3.4). A transcranial magnetic stimulation (N = 24) study found that 58% of participants with mild TBI-related headache experienced a 50% reduction in headache frequency.

Summary

New studies indicate promise in improving clinically important outcomes of PTH. However, more research is necessary to determine the optimal treatment and whether combining pharmacologic and nonpharmacologic treatment versus a single modality is more effective.

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Data Availability

No datasets were generated or analyzed during the current study.

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Authors and Affiliations

  1. Department of Neurology, NYU Langone Health, 222 East 41st Street, New York, NY, 10017, USA

    Mia T. Minen, Erin K. Waire, Alexis George & Shae Datta

  2. Department of Population Health, NYU Langone Health, 222 East 41st Street, New York, NY, 10017, USA

    Mia T. Minen

  3. Macaulay Honors College, the City College of New York, New York, NY, USA

    Naoroz Mahmood & Fardin Khan

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Minen, M.T., Mahmood, N., Khan, F. et al. Treatment Options for Posttraumatic Headache: A Current Review of the Literature. Curr Pain Headache Rep 28, 205–210 (2024). https://doi.org/10.1007/s11916-023-01199-y

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