TY - JOUR
T1 - Prevalence of and Risk Factors for Post-traumatic Headache in Civilian Patients After Mild Traumatic Brain Injury
T2 - A TRACK-TBI Study
AU - TRACK-TBI Investigators
AU - Ashina, Håkan
AU - Dodick, David W.
AU - Barber, Jason
AU - Temkin, Nancy R.
AU - Chong, Catherine D.
AU - Adler, Jennifer S.
AU - Stein, Ken Shubin
AU - Schwedt, Todd J.
AU - Manley, Geoffrey T.
AU - Badjatia, Neeraj
AU - Feeser, V. Ramana
AU - Gopinath, Shankar
AU - Grandhi, Ramesh
AU - Keene, C. Dirk
AU - Kitagawa, Ryan
AU - Korley, Frederick K.
AU - Donald, Christine Mac
AU - Madden, Christopher
AU - Mukherjee, Pratik
AU - Ngwenya, Laura B.
AU - Okonkwo, David
AU - Robertson, Claudia
AU - Rodgers, Richard B.
AU - Schnyer, David
AU - Taylor, Sabrina R.
AU - Vassar, Mary
AU - Yue, John K.
AU - Zafonte, Ross
N1 - Publisher Copyright:
© 2023 Mayo Foundation for Medical Education and Research
PY - 2023/10
Y1 - 2023/10
N2 - Objective: To ascertain the prevalence of and risk factors for post-traumatic headache (PTH) attributed to mild traumatic brain injury (mTBI). Patients and Methods: A prospective, longitudinal, multicenter cohort study of patients with mTBI and orthopedic trauma controls who were enrolled from February 26, 2014, to August 8, 2018. The baseline assessment was conducted as soon as possible following evaluation at the emergency department. Follow-ups were scheduled at 2 weeks, 3 months, 6 months, and 12 months postinjury. Eligible patients with mTBI included those 18 years of age or older who presented to the emergency department within 24 hours of head injury warranting evaluation by noncontrast head computed tomography scan. Acute PTH was considered present when a patient reported a headache score of greater than or equal to 2 on the Rivermead Post-concussion Questionnaire at 2 weeks postinjury (ie, headache is at least a mild problem compared with pre-injury). Persistent PTH was defined when a patient with acute PTH reported a Rivermead Post-concussion Questionnaire headache score of greater than or equal to 2 at the scheduled follow-up examinations. Results: Acute PTH was reported by 963 (60.4%) of 1594 patients with mTBI at 2 weeks postinjury. Among those with acute PTH, 439 (52.4%) of 837 patients reported persistent PTH at 3 months postinjury. This figure decreased over time and 278 (37.5%) of 742 patients continued to report persistent PTH at 6 months, whereas 187 (28.9%) of 646 patients did so as well at 12 months postinjury. Risk factors for acute PTH included younger age, female sex, fewer years of formal education, computed tomography–positive scans, alteration of consciousness, psychiatric history, and history of migraine. Risk factors for persistent PTH included female sex, fewer years of formal education, and history of migraine. Conclusion: Post-traumatic headache is a prevalent sequela of mTBI that persists for at least 12 months in a considerable proportion of affected individuals. The attributable burden necessitates better patient follow-up, disease characterization, improved awareness of PTH in clinical practice, and identification of effective therapies.
AB - Objective: To ascertain the prevalence of and risk factors for post-traumatic headache (PTH) attributed to mild traumatic brain injury (mTBI). Patients and Methods: A prospective, longitudinal, multicenter cohort study of patients with mTBI and orthopedic trauma controls who were enrolled from February 26, 2014, to August 8, 2018. The baseline assessment was conducted as soon as possible following evaluation at the emergency department. Follow-ups were scheduled at 2 weeks, 3 months, 6 months, and 12 months postinjury. Eligible patients with mTBI included those 18 years of age or older who presented to the emergency department within 24 hours of head injury warranting evaluation by noncontrast head computed tomography scan. Acute PTH was considered present when a patient reported a headache score of greater than or equal to 2 on the Rivermead Post-concussion Questionnaire at 2 weeks postinjury (ie, headache is at least a mild problem compared with pre-injury). Persistent PTH was defined when a patient with acute PTH reported a Rivermead Post-concussion Questionnaire headache score of greater than or equal to 2 at the scheduled follow-up examinations. Results: Acute PTH was reported by 963 (60.4%) of 1594 patients with mTBI at 2 weeks postinjury. Among those with acute PTH, 439 (52.4%) of 837 patients reported persistent PTH at 3 months postinjury. This figure decreased over time and 278 (37.5%) of 742 patients continued to report persistent PTH at 6 months, whereas 187 (28.9%) of 646 patients did so as well at 12 months postinjury. Risk factors for acute PTH included younger age, female sex, fewer years of formal education, computed tomography–positive scans, alteration of consciousness, psychiatric history, and history of migraine. Risk factors for persistent PTH included female sex, fewer years of formal education, and history of migraine. Conclusion: Post-traumatic headache is a prevalent sequela of mTBI that persists for at least 12 months in a considerable proportion of affected individuals. The attributable burden necessitates better patient follow-up, disease characterization, improved awareness of PTH in clinical practice, and identification of effective therapies.
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U2 - 10.1016/j.mayocp.2023.02.026
DO - 10.1016/j.mayocp.2023.02.026
M3 - Article
C2 - 37480909
AN - SCOPUS:85165663920
SN - 0025-6196
VL - 98
SP - 1515
EP - 1526
JO - Mayo Clinic Proceedings
JF - Mayo Clinic Proceedings
IS - 10
ER -