A Comprehensive Approach to the Assessment and Management of Posttraumatic Headache

Area of Science:

• Neurology
• Trauma Care
• Pain Management

Background:

• Posttraumatic headache (PTH) is a frequent consequence of mild traumatic brain injury (mTBI).
• PTH often presents similarly to migraine or tension-type headaches but is a distinct clinical entity.
• Persistent PTH risk increases with co-occurring mTBI symptoms, postconcussive symptoms, and comorbidities.

Purpose of the Study:

• To review the existing evidence for pharmacologic and nonpharmacologic treatments for PTH.
• To propose a multidisciplinary treatment strategy for PTH based on mTBI management principles.

Main Methods:

• Literature review of current evidence for PTH treatments.
• Analysis of pharmacologic and nonpharmacologic interventions.
• Synthesis of findings to propose a treatment framework.

Main Results:

• Current pharmacologic management of PTH is primarily guided by headache phenotype, lacking robust research support.
• Evidence for nonpharmacologic interventions is also limited but growing.
• A significant gap exists in high-quality research for effective PTH treatments.

Conclusions:

• A multidisciplinary approach, integrating mTBI principles, is recommended for managing PTH.
• Further high-quality research is essential to guide evidence-based pharmacologic and nonpharmacologic treatments for PTH.
• Tailoring treatment to individual patient needs and co-occurring conditions is crucial.