Lew HL, Lin P-H, Fuh J-L, Wang S-J, Clark DJ, Walker WC: Characteristics and treatment of headache after traumatic brain injury: A focused review. Am J Phys Med Rehabil 2006;85:619–627.
Headache is one of the most common complaints in patients with traumatic brain injury. By definition, headache that develops within 1 wk after head trauma (or within 1 wk after regaining consciousness) is referred to as posttraumatic headache (PTH). Although most PTH resolves within 6–12 mos after injury, approximately 18–33% of PTH persists beyond 1 yr. We performed a systematic literature review on this topic and found that many patients with PTH had clinical presentations very similar to tension-type headache (37% of all PTH) and migraine (29% of all PTH). Although there is no universally accepted protocol for treating PTH, many clinicians treat PTH as if they were managing primary headache. As a result of the heterogeneity in the terminology and paucity in prospective, well-controlled studies in this field, there is a definite need for conducting double-blind, placebo-controlled treatment trials in patients with PTH.
From the Veterans Affairs Palo Alto Health Care System, Palo Alto, California (HLL, DJC); Stanford University School of Medicine, Stanford, California (HLL, DJC); Harvard School of Public Health, Boston, Massachusetts (P-HL); The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan (J-LF, S-JW); the National Yang-Ming University Schools of Medicine, Taipei, Taiwan (J-LF, S-JW); and Hunter McGuire VAMC, Richmond, Virginia (WCW).
All correspondence and requests for reprints should be addressed to Pei-Hsin Lin, MD, Harvard School of Public Health, 677 Huntington Avenue, Boston MA 02115.