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Chronic post-traumatic headache--a clinical analysis in relation to the International Headache Classification 2nd
1Danish Headache Centre, Department of Neurology, University of Copenhagen, Glostrup Hospital, 2600 Glostrup, Denmark. baandrup@webspeed.dk
Cephalalgia : an International Journal of Headache
|January 22, 2005
Summary
Chronic post-traumatic headache (CPTH) is often heterogeneous, frequently resembling chronic tension-type headache. Treatment outcomes for CPTH patients with analgesic overuse were favorable, unlike multidisciplinary approaches.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Chronic post-traumatic headache (CPTH) is a significant clinical challenge following head injury.
- Understanding CPTH's clinical presentation is crucial for effective management.
Purpose of the Study:
- To analyze and classify the clinical presentation of CPTH patients.
- To compare diagnostic criteria between the 1st and 2nd Editions of the International Headache Classification.
- To evaluate treatment outcomes in CPTH, particularly concerning analgesic overuse.
Main Methods:
- Analysis of clinical data from 53 CPTH patients at a specialized headache clinic.
- Classification of headache types according to the International Headache Classification (IHC) 1st and 2nd Editions.
- Assessment of analgesic overuse prevalence and treatment outcomes.
Main Results:
- All patients met criteria for both IHC editions, indicating minimal impact of 2nd Edition changes in specialized settings.
- 77% of patients exhibited headache resembling chronic tension-type headache, often with migraine features.
- Episodic tension-type headache was identified as a post-traumatic presentation for the first time.
- 42% of patients had coexisting analgesic overuse with favorable treatment outcomes.
- Multidisciplinary treatment showed only modest results.
Conclusions:
- CPTH presents heterogeneously, frequently mimicking chronic tension-type headache.
- The 2nd Edition of the IHC does not significantly alter CPTH prevalence in specialized clinics.
- Analgesic overuse in CPTH patients responds well to treatment, contrasting with limited success of multidisciplinary approaches.
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