Post-traumatic headache after mild traumatic brain injury in a one-year follow up study – risk factors and return to work

The Journal of Headache and Pain

Ivan Marinkovic¹  Susanna Melkas¹  Antti Huovinen¹  Hanna Harno¹  Yvonn Kraemer²  Harri Isokuortti³  Kaisa Mäki⁴  Taina Nybo⁴  Antti Korvenoja⁵ 

[1] Department of Neurology, Clinical Neurosciences, Helsinki University Hospital and University of Helsinki, Helsinki, Finland;Department of Neurology, Clinical Neurosciences, Helsinki University Hospital and University of Helsinki, Helsinki, Finland;Department of Neurology, Helsinki University Hospital, University of Helsinki, P.O.Box 340, Haartmaninkatu 4, 00029, Helsinki, Finland;Department of Neurosurgery, Clinical Neurosciences, Helsinki University Hospital and University of Helsinki, Helsinki, Finland;Division of Neuropsychology, HUS Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland;HUS Diagnostic Centre, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;

关键词: Risk factor;    Brain injury;    mTBI;    Post-traumatic;    Headache;    PTH;   

DOI  :  10.1186/s10194-022-01398-9

来源: Springer

【 摘 要 】

BackgroundPost-traumatic headache (PTH) is a common symptom following mild traumatic brain injury (mTBI). Patients at risk to develop acute PTH (aPTH) and further persistent PTH (pPTH) need to be recognized.MethodsThis is a one-year follow-up of 127 patients with mTBI, aged 18 to 68, referred to outpatient clinic in the Helsinki University Hospital. Symptoms were assessed at the emergency department (ED), with structured interview at outpatient clinic visit and with Rivermead post-concussion symptom questionnaire at one, three, and 12 months after injury. Psychiatric disorders were assessed with Structured Clinical Interview for DSM-IV Axis I disorders at 3-4 months and return to work (RTW) from patient records.ResultsAt one month, 77/127 patients (61%) had aPTH. According to multiple logistic regression analysis, risk factors for aPTH were headache at the emergency department (ED) (OR 5.43), other pain (OR 3.19), insomnia (OR 3.23), and vertigo (OR 5.98). At three months, 17 patients (22% of aPTH patients) had developed pPTH, and at one year, 4 patients (24% of pPTH patients) still presented with pPTH. Risk factors for pPTH at three months were older age (OR 1.06) and current insomnia (OR 12.3). The frequency of psychiatric disorders did not differ between the groups. pPTH patients performed worse on their RTW.ConclusionsRisk factors for aPTH were insomnia, headache at ED, other pain, and vertigo and for pPTH, insomnia and older age. RTW rate was lower among pPTH patients.

【 授权许可】

CC BY