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Updated: Feb 27, 2026
Systems Analysis of the Neuroinflammatory and Hemodynamic Response to Traumatic Brain Injury
Published on: May 27, 2022
Post-traumatic headache in patients with minimal traumatic intracranial hemorrhage after traumatic brain injury: a
Chang-Ki Hong1,2, Yu Shik Shim3, Sook Young Sim4
1Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, Seoul, 06273, Republic of Korea.
Background:
No evidence is available on the risks of neurologically asymptomatic minimal traumatic intracranial hemorrhage (mTIH) in patients with traumatic brain injury (TBI) for post-traumatic headache (PTH). The purpose of this study was to investigate whether mTIH in patients with TBI was associated with PTH and to evaluate its risk factors.
Methods:
Between September 2009 and December 2014, 1484 patients with TBI were treated at our institution, 57 of whom had mTIH after TBI and were include in this study. We performed propensity score matching to establish a control group among the 823 patients with TBI treated during the same period. Patients with TBI rated their headaches prospectively using a numeric rating scale (NRS). We compared NRS scores between mTIH group (n = 57) and non-mTIH group (n = 57) and evaluated risk factors of moderate-to-severe PTH (NRS ≥ 4) at the 12-month follow-up.
Results:
Moderate-to-severe PTH was reported by 21.9% of patients (29.8% in mTIH group and 14.0% in non-mTIH group B, p = 0.012) at the 12-month follow-up. The mean NRS was higher in mTIH group than in non-mTIH group throughout the follow-up period (95% confidence interval [CI], 0.11 to 1.14; p < 0.05, ANCOVA). Logistic regression analysis showed that post-traumatic seizure (odds ratio, 1.520; 95% CI, 1.128-6.785; p = 0.047) and mTIH (odds ratio, 2.194; 95% CI, 1.285-8.475; p = 0.039) were independently associated with moderate-to-severe PTH at the 12-month follow-up.
Conclusions:
Moderate-to-severe PTH can be expected after TBI in patients with mTIH and post-traumatic seizure. PTH occurs more frequently in patients with mTIH than in those without mTIH.
Insights
Minimal traumatic intracranial hemorrhage (mTIH) after traumatic brain injury (TBI) is linked to a higher risk of developing moderate-to-severe post-traumatic headache (PTH). Post-traumatic seizures also increase PTH risk in TBI patients.
Area of Science:
- Neurology
- Neurosurgery
- Trauma Care
Background:
- Limited evidence exists on the risk of neurologically asymptomatic minimal traumatic intracranial hemorrhage (mTIH) in patients with traumatic brain injury (TBI) concerning post-traumatic headache (PTH).
- Understanding this association is crucial for managing TBI patients and predicting headache development.
Purpose of the Study:
- To investigate the association between mTIH in TBI patients and the development of PTH.
- To identify risk factors contributing to PTH in this patient population.
Main Methods:
- A cohort of 1484 TBI patients was analyzed, with 57 identified as having mTIH.
- Propensity score matching was used to create a control group of 57 patients without mTIH.
- Patients prospectively rated headache severity using a numeric rating scale (NRS) over a 12-month follow-up period.
Main Results:
- Moderate-to-severe PTH (NRS ≥ 4) was reported by 29.8% of patients with mTIH compared to 14.0% without mTIH (p=0.012).
- The mean NRS was significantly higher in the mTIH group throughout the follow-up.
- Independent risk factors for moderate-to-severe PTH included post-traumatic seizure (OR, 1.520) and mTIH (OR, 2.194).
Conclusions:
- Moderate-to-severe PTH is more frequent in TBI patients with mTIH compared to those without.
- The presence of mTIH and post-traumatic seizures are significant predictors of moderate-to-severe PTH after TBI.
