Chronic post-traumatic headache: clinical, psychopathological features and outcome determinants

Area of Science:

• Neurosurgery
• Neurology
• Epidemiology

Background:

• Chronic Post-Traumatic Headache (CPTH) is a significant complication following head injuries.
• Understanding its epidemiological and clinical profile is crucial for effective management.

Purpose of the Study:

• To investigate the incidence, clinical characteristics, and potential contributing factors of CPTH in hospitalized head injury patients.
• To explore the relationship between CPTH severity, neurological findings, and psychological profiles.

Main Methods:

• Retrospective study of 57 patients with CPTH out of 130 hospitalized for closed head injuries.
• Clinical data collection including injury severity, headache characteristics, CT scan results, and MMPI profiles.
• Statistical analysis to identify correlations between CPTH and various clinical and psychological parameters.

Main Results:

• CPTH incidence was 44% in the studied population.
• Chronic muscle contraction headache was the most common type, followed by migraine.
• Moderate correlation found between CPTH severity, consciousness disturbance, and positive CT findings.
• Severe CPTH group showed higher MMPI scores for hypochondriasis, depression, hysteria, and schizophrenia.
• Age, unconsciousness duration, neurological deficits, and litigation status were not linked to CPTH occurrence or outcome.

Conclusions:

• CPTH exhibits considerable variability in presentation and onset following head trauma.
• Both physical (e.g., CT findings) and psychological determinants (e.g., personality traits, maladjustment) are important in CPTH pathogenesis.
• Further research into the interplay of physical and psychological factors is warranted for comprehensive CPTH management.