Posttraumatic headache: permanency and relationship to legal settlement

Area of Science:

• Neurology
• Forensic Medicine
• Pain Management

Background:

• Subjective symptoms like posttraumatic headache (PTH) present challenges in legal claims, where permanency must often be established.
• Societal attitudes sometimes suggest PTH resolves after legal claims are settled.

Purpose of the Study:

• To evaluate the reliability of criteria used to diagnose "permanent" posttraumatic headache.
• To determine if diagnosed permanent PTH symptoms persist after legal settlement.

Main Methods:

• Retrospective study involving structured telephone interviews.
• Fifty adult outpatients diagnosed with permanent PTH and whose litigation was settled at least one year prior were interviewed.
• Exclusion criteria included previous headaches, accidents, or head injuries.

Main Results:

• All fifty interviewed patients reported persistent headache symptoms one year or more post-legal settlement.
• The criteria used for diagnosing permanency (PTH >1 year with no improvement, or PTH >6 months with plateau and treatment) appeared reliable.
• Only four patients reported any improvement in their headache pattern after legal settlement.

Conclusions:

• The diagnostic criteria for permanent posttraumatic headache appear reliable in clinical practice.
• Posttraumatic headache symptoms often persist long after legal claims are resolved, challenging the notion of resolution post-settlement.