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Related Concept Videos

Post-traumatic Stress Disorder01:27

Post-traumatic Stress Disorder

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Post-traumatic stress disorder (PTSD) is a psychiatric condition that arises following exposure to traumatic events such as natural disasters, forced displacement, or severe accidents. It significantly impairs individuals' ability to cope with daily activities and disrupts their emotional and psychological equilibrium.
Symptoms and Behavioral Manifestations
A spectrum of distressing symptoms characterizes PTSD. Recurrent flashbacks, where individuals involuntarily relive traumatic events,...
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Persistent posttraumatic headaches and functioning in veterans: Injury type can matter.

Paul S Nabity1,2, Carlos A Jaramillo3,4, Patricia A Resick5

  • 1Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.

Headache
|September 27, 2021
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Summary

Combined head injuries increase the risk of chronic posttraumatic headaches (PTHs) in veterans. Understanding these injury types is crucial for developing effective treatments for persistent headaches after traumatic brain injury (TBI).

Keywords:
blastheadachemigraineposttraumatictraumatic brain injuryveteran

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Area of Science:

  • Neuroscience
  • Traumatic Brain Injury Research
  • Headache Medicine

Background:

  • Posttraumatic headaches (PTHs) are a common and debilitating consequence of traumatic brain injury (TBI).
  • Over 400,000 veterans have reported TBI, highlighting the need to understand PTH predictors.
  • Identifying factors influencing PTH development is key for advancing treatment strategies.

Purpose of the Study:

  • To investigate the relationship between different head trauma types and subsequent headache presentations.
  • To characterize the impact of blast injury, blunt injury, and combined blast+blunt injury on headache characteristics and functioning.
  • To identify predictors of chronic versus episodic PTHs based on injury mechanism.

Main Methods:

  • A nested-cohort design was employed, analyzing baseline data from 190 participants in a cognitive behavioral therapy trial for PTH.
  • Participants had experienced PTH resulting from blast and/or blunt head trauma and presented with PTSD symptoms.
  • Headaches were phenotyped using the Structured Diagnostic Interview for Headache-Revised, and head injury histories were assessed using the Ohio State University Traumatic Brain Injury Identification Method.

Main Results:

  • Individuals with persistent PTH following combined blast and blunt head trauma were significantly more likely to experience chronic PTH compared to those with blunt trauma only (70% vs. 40%) or blast trauma only (70% vs. 48%).
  • No significant differences were observed across head injury types regarding headache-related disability, depression symptoms, or PTSD symptom severity.
  • The odds ratio for chronic PTH in the combined injury group was 3.45 compared to blunt trauma only and 2.51 compared to blast trauma only.

Conclusions:

  • The combination of blast and blunt head injuries is associated with an increased likelihood of headache chronicity.
  • Head injury type did not influence headache-related disability or the severity of associated psychological symptoms.
  • Further research is warranted to explore the additive and synergistic effects of distinct head injuries on the refractory nature of chronic headaches.