Brain structure is different in persistent post-traumatic headache vs. migraine

Many people who experience traumatic brain injury (TBI) report headaches during the recovery period. These post-traumatic headaches are considered “persistent” when they last for three or more months after the initial injury, and the symptoms are often indistinguishable from migraine headaches. Symptoms of post-traumatic headaches and symptoms of migraines overlap significantly, but the underlying causes may be different. Although both TBI and migraine patients may experience similar pain and negative outcomes as a result of their headaches, clinicians must consider structural differences between the two headache types when creating tailored treatment plans.

To better understand the physical differences between post-traumatic headaches and non-injury-related migraines, a group of researchers used magnetic resonance imaging (MRI) to examine the brain structure of twenty-eight individuals with post-traumatic headaches and twenty-eight individuals with migraine. They found that the two headache groups were displayed significant differences in brain structure, including volume, thickness, area, and curvature of the brain.

MRI data indicates that individuals with persistent post-traumatic headaches have different brain structure than those with non-injury-related migraines, suggesting that trauma-related headaches are caused by different physiological processes than those that cause migraine. Further research is necessary to develop an injury-specific headache treatment plan, and clinicians are encouraged to consider post-traumatic headaches and migraines as distinct headache types when providing symptom management.

Schwedt TJ, Chong CD, Peplinski J, et al. Persistent post-traumatic headache vs. migraine: an MRI study demonstrating differences in brain structure. The Journal of Headache and Pain. (August 2017).

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