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Published on: January 20, 2023
Head or neck injury increases the risk of chronic daily headache: a population-based study
James R Couch1, Richard B Lipton, Walter F Stewart
1Department of Neurology, University of Oklahoma Medical School, Oklahoma City, OK 73104, USA.
Insights
Head and neck injuries (HANI) contribute to approximately 15% of chronic daily headaches (CDH) in the general population. The risk of developing CDH increases with the number of head and neck injuries experienced over a lifetime.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Head injury is a known risk factor for persistent headaches, with 20-30% of patients experiencing headaches 12-24 months post-injury.
- A significant subset of these patients, up to 50%, develop chronic daily headaches (CDH).
- The specific contribution of head and neck injury (HANI) to CDH in the general population remains under-evaluated.
Purpose of the Study:
- To quantify the association between lifetime head and neck injuries (HANI) and chronic daily headaches (CDH).
- To assess the attributable risk of HANI in the development of CDH within a non-clinical population.
Main Methods:
- Utilized data from the Frequent Headache Epidemiology Study, comparing individuals with CDH to those with episodic headache (EH).
- Assessed lifetime occurrence of HANI, categorizing injuries as potentially precipitating (PPI) if occurring within two years of headache onset.
- Analyzed the relationship between HANI and CDH using logistic regression and trend analysis.
Main Results:
- Lifetime HANI was significantly more frequent in CDH cases compared to EH controls across genders (OR 1.7 overall).
- HANI accounted for an estimated 15% of CDH cases (11% in women, 36% in men).
- A dose-response relationship was observed, with increasing numbers of HANI correlating with higher odds of CDH (p < 0.05).
Conclusions:
- Head and neck injuries are a significant factor, contributing to approximately 15% of chronic daily headache cases in the general population.
- The link between HANI and CDH extends beyond injuries immediately preceding headache onset.
- The cumulative number of head and neck injuries experienced throughout life is associated with an increased lifetime risk of developing chronic daily headaches.
Objective:
To evaluate the extent to which head and neck injury (HANI) contributes to chronic daily headache (CDH).
Background:
In prospective studies, head injury is associated with headache (HA) that remains a problem at 12 to 24 months post-head injury in 20 to 30% of patients. Of these, up to 30 to 50% manifest CDH. The degree to which head injury contributes to CDH has not been evaluated in a non-clinical population. We evaluate the relationship between lifetime occurrence of HANI and CDH in a randomly chosen population sample.
Methods:
Study participants are from the Frequent Headache Epidemiology Study. Cases with CDH (> or =180 HA/year) and a comparison group with episodic headache (EH, 2 to 102 HA/year) were identified from the general population. Subjects were asked about lifetime occurrence of HANI. HANI were further classified as potentially precipitating injuries (PPI) if they occurred within 2 years of CDH onset for cases or in an equivalent 2-year period for EH controls.
Results:
Lifetime occurrence of HANI was more frequent in cases than controls for men (adjusted OR = 3.1 [1.3 to 7.2]), women (OR = 1.5 [0.97 to 2.3]), and overall (OR = 1.7 [1.1 to 2.4]). The attributable risk was 15% (36% men, 11% women). Results were similar for PPI. The odds of CDH increased with the number of lifetime HANI in all groups (p < 0.05 trend).
Conclusions:
Results suggest that head and neck injury (HANI) accounts for approximately 15% of chronic daily headache (CDH) cases in this non-clinical population. The relationship between HANI and CDH was not limited to injuries proximate to CDH onset. The lifetime risk of CDH increases with increasing number of HANI.
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