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Chronic post-traumatic headache after mild head injury: a descriptive study
Dorte Kjeldgaard1, Hysse Forchhammer, Tom Teasdale
1Danish Headache Center, University of Copenhagen, Denmark.
Insights
Chronic post-traumatic headache (CPTH) patients experience more cognitive and somatic symptoms, impacting daily function. A significant portion also show signs of post-traumatic stress disorder (PTSD), suggesting a link to prolonged illness and work incapacity.
Area of Science:
- Neurology
- Psychiatry
- Public Health
Background:
- The causes of chronic post-traumatic headache (CPTH) following mild head injury remain unclear.
- Effective management strategies for CPTH are complex and require further understanding.
- Characterizing the CPTH population is essential for optimizing treatment approaches.
Purpose of the Study:
- To characterize patients suffering from chronic post-traumatic headache (CPTH).
- To identify key differences between CPTH patients and those with chronic primary headaches.
- To explore potential contributing factors to the prolonged illness in CPTH.
Main Methods:
- Ninety CPTH patients and 45 chronic primary headache patients were enrolled.
- Data collection included demographic and headache information, alongside validated questionnaires (HTQ, Rivermead, SF-36) and headache diaries.
- Assessment included the Harvard Trauma Questionnaire (HTQ) to evaluate post-traumatic stress disorder (PTSD) symptoms.
Main Results:
- CPTH patients reported significantly more cognitive and somatic symptoms compared to controls.
- Self-perceived health was more affected in CPTH patients regarding physical and social function.
- A notable 31% of CPTH patients met the threshold for post-traumatic stress disorder (PTSD) on the HTQ, and more were unemployed.
Conclusions:
- CPTH is associated with significant disability and loss of work capacity.
- The high prevalence of PTSD symptoms in CPTH patients warrants further investigation.
- Understanding the role of PTSD in CPTH may reveal crucial factors explaining prolonged illness and disability.
Background:
The aetiology behind chronic post-traumatic headache (CPTH) after mild head injury is unclear and management is complicated. In order to optimize treatment strategies we aimed to characterize a CPTH population.
Methods:
Ninety patients with CPTH and 45 patients with chronic primary headaches were enrolled from the Danish Headache Center. All patients were interviewed about demographic and headache data. They completed the Harvard Trauma Questionnaire (HTQ), Rivermead Post Concussion Symptoms Questionnaire, SF-36 and a headache diary.
Results:
The CPTH group experienced more cognitive ( P < 0.001) and somatic symptoms ( P = 0.048) and rated their self-perceived health as more affected in terms of physical function ( P = 0.036), physical role function ( P = 0.012) and social function ( P = 0.012) than the control group. Surprisingly, 31% of the CPTH group had a score equal to or above the cut-off score for having post-traumatic stress disorder (PTSD) according to the HTQ. In terms of demographics and headache, the groups were comparable except the CPTH group were more often without affiliation to the labour market ( P < 0.001).
Conclusions:
The loss of work capacity and high levels of disability for the CPTH patients suggests directions for further research into what important factors are embedded in the patients' PTSD symptoms and might explain their prolonged illness.
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