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Headache is common in the first three months after mild traumatic brain injury

Millions of people each year sustain a mild traumatic brain injury (mTBI), also known as concussion. Although most symptoms of mTBI typically resolve within a few weeks, some people experience persistent post-concussive symptoms, which linger for more than three months after the initial injury. Current TBI research indicates that headache is among the most common of these symptoms. However, researchers remain unsure if certain factors can predict which patients are at risk for persistent headaches in the months following mTBI. Because these patients may require clinical support to manage long-term headache, health care providers need a reliable way to identify high-risk mTBI patients who will benefit from early prevention and intervention strategies.

A recent study in Norway examined the relationship between mTBI and headache symptoms to determine predictors of acute versus persistent headache in individuals who sustained a concussion. Researchers gathered information from 378 patients aged 16 to 49 years old who sustained an mTBI between 2014 and 2015. For comparison, they also collected data from 82 people who sustained non-TBI physical trauma and 83 healthy, non-injured people. They found that:

  • People who sustained an mTBI were significantly more likely to experience headaches in the first three months after injury than people who did not experience a head injury. However, by three months to one year after injury, people with mTBI typically experienced headaches at the same rate as the non-injured population.
  • Acute headache (lasting for three months or less after mTBI) was most common among women and among people who showed abnormal findings on brain imaging procedures, such as computerized tomography (CT) and magnetic resonance imaging (MRI).
  • People were more likely to experience persistent headaches (lasting more than three months), if they were injured under the influence of alcohol or had a history of prior concussions.

People with mTBI are likely to experience headaches as a result of their injuries. Fortunately, these headaches typically endure for less than three months, and the majority of cases resolve within one year after injury. Clinicians are advised to watch for signs of persistent headaches in mTBI patients (particularly those who have a history of concussion or who chronically consume alcohol) to ensure that patients receive adequate treatment for this painful condition.

Nordhaug LH, Linde M, Follestad T, et al. Change in headache suffering and predictors of headache after mild traumatic brain injury: A population-based, controlled, longitudinal study with twelve-month follow-up. Journal of Neurotrauma. (December 2019).

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