[Chronic post-traumatic headache and brain perfusion changes assessed using magnetic resonance imaging]

Headache after a head injury is one of the most frequent symptoms in patients after craniocerebral trauma. The aim of the study was to investigate changes in brain perfusion in patients with chronic post-traumatic headache a long time after craniocerebral trauma. PWI gives us the exact information about the brain circulation.

Clinical measures included 52 patients (24 women and 28 men) aged from 20 to 56 years (mean age 42.3 years) suffering from chronic post-traumatic headache after moderate and severe craniocerebral trauma, 6-18 months after the head injury. The Glasgow Coma Scale (GCS) and Abbreviated Injury Scale (AIS) were used to evaluate the severity of the head injury. The PWI (Perfusion Weighted Imaging) study was made in all patients.

In the study group in the PWI study the domination of perfusion disturbances in frontal lobes were seen in 38 patients (59.6%). Statistical analysis showed no significant correlation between character, intensity, localization of headache and changes in the PWI. In 22 patients with localized headache the highest percentage of changes in PWI matched with localization of headache were observed in frontal lobes--40.9% in the right frontal lobe, 31.8% in the left frontal lobe, and in the right temporal lobe--22.7%. In accessible references no publications concerning changes in the PWI in chronic post-traumatic headache were found.

The results suggest the occurrence of brain perfusion disturbances a long time after craniocerebral trauma, which were most marked in frontal lobes, without any statistically significant correlation with chronic post-traumatic headache.