The course of headache in patients with moderate-to-severe headache due to mild traumatic brain injury: a retrospective cross-sectional study

The Journal of Headache and Pain

Research Article

Min A Kwon¹  Jin-Yang Joo¹  Yong Bae Kim¹  Chang-Ki Hong²  Joonho Chung³  Yu Shik Shim⁴  Sook Young Sim⁵ 

[1] Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, 135-720, Seoul, Republic of Korea;Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, 135-720, Seoul, Republic of Korea;Severance Institute for Vascular and Metabolic Research, Yonsei University, Seoul, Republic of Korea;Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, 135-720, Seoul, Republic of Korea;Severance Institute for Vascular and Metabolic Research, Yonsei University, Seoul, Republic of Korea;Department of Neurological Surgery, Rush University Medical Center, 1725 W. Harrison St., Professional Building Suite 855, 60612, Chicago, IL, USA;Department of Neurosurgery, Inha University School of Medicine and Hospital, Incheon, Republic of Korea;Department of Neurosurgery, Inje University Seoul Paik Hospital, Seoul, Republic of Korea;

关键词: Headache;    Head injury;    Post-traumatic headache;    Traumatic brain injury;   

DOI  :  10.1186/s10194-017-0755-9

 received in 2017-03-11, accepted in 2017-04-12,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundLittle is known about the long-term course of headache in patients with moderate-to-severe headache due to traumatic brain injury (TBI). We evaluated the course of headache in patients with moderate-to-severe headache due to mild TBI.MethodsSince September 2009, patients with TBI prospectively rated their headache using a numeric rating scale (NRS). From the database containing 935 patients with TBI between September 2009 and December 2013, 259 patients were included according to following criteria: (1) newly onset moderate-to-severe headache (NRS ≥ 4) due to head trauma; (2) age ≥ 15 years; (3) Glasgow Coma Scale ≥ 13; (4) transient loss of consciousness ≤ 30 min; and (5) radiographic evaluation, such as computed tomography or magnetic resonance image. We evaluated initial and follow-up NRS scores to determine the significance of NRS changes and identified risk factors for moderate-to-severe headache at 36-month follow-up.ResultsAt 36-month follow-up, 225 patients (86.9%) reported improved headache (NRS ≤ 3) while 34 (13.1%) reported no improvement. The NRS scores were significantly decreased within a month (P < 0.001). The follow-up NRS scores at 12-, 24-, and 36-months were lower than those at one month (P < 0.001). Multiple logistic regression analysis showed that post-traumatic seizure (odds ratio, 2.162; 95% CI, 1.095–6.542; P = 0.041) and traumatic intracranial hemorrhage (odds ratio, 2.854; 95% CI, 1.241–10.372; P = 0.024) were independent risk factors for moderate-to-severe headache at 36-month follow-up.ConclusionsThe course of headache in patients with mild TBI continuously improved until 36-month follow-up. However, 13.1% of patients still suffered from moderate-to-severe headache at 36-month follow-up, for whom post-traumatic seizure and traumatic intracranial hemorrhage might be risk factors.

【 授权许可】

CC BY   
© The Author(s). 2017