Abstract

Traumatic brain injury is a common and major cause of disability and death that might require emergency neurological and neurosurgical interventions. Traumatic brain injury can result in temporary or permanent physical, cognitive and psychological impairments. One of the most common complications associated with traumatic brain injury is post-traumatic headache, associated with significant disability and reduced quality of life. Post-traumatic headache is a public health concern that can affect the long-term outcome of traumatic brain injury patients. Clinical symptoms of post-traumatic headache significantly overlap with common primary headaches such as migraine and tension-type headaches. Beyond neurobiological factors, psychological factors can play crucial roles in the initiation and sustainment of post-traumatic headache. While neurological mechanisms underlying post-traumatic headache remains unknown, different studies suggest various mechanisms such as physical damages to the cranial nerves and neck structure, hyper-sensitization of the pain modulatory pathway, and inflammation as underlying causes for the neurobiology of headache. I explore the hypothesis that traumatic brain injury is associated with headaches. In particular, I provide an overview of the neurobiology of post-traumatic headache, its diagnosis, presenting recent findings on the etiology, explaining similarities and differences between with primary headaches such as migraine and tension-type headache, discuss pharmacological and non-pharmacological interventions for the treatments, as well as emphasising on the psychological importance of post-traumatic headache.

Highlights

  • Traumatic brain injury (TBI) is a preventable injury caused by external biomechanical forces exerted on the head

  • One major limitation is that many TBI patients can have comorbidities which can act as confounding factors to affect the phenotypes observed from radiological and neurophysiological data [122]

  • A holistic and personalized approach to integrating pharmacological and non-pharmacological interventions such as lifestyle modifications and stress management can effectively treat persistent post-traumatic headache (PTH) [130]. In addition to their headache, TBI patients can suffer from other symptoms, including anxiety, depression, post-traumatic stress disorder (PTSD), which requires medications [193, 194]

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Summary

Introduction

Traumatic brain injury (TBI) is a preventable injury caused by external biomechanical forces exerted on the head. Subconcussive head trauma does not result in any obvious clinical symptoms, repetitive mild head TBI is the underlying reason for chronic traumatic encephalopathy [7]. This is a progressive neurodegenerative disorder characterized by the deposition of hyperphosphorylated tau at a depth of sulci among contact sports participants and military veterans [14]. A study suggested that variations in reporting the frequency of the post-concussion syndrome could be related to cultural differences [40] Others corroborated these findings by showing that culture and language background could affect how patients report their symptoms. PTH can be associated with other psychiatric disorders such as post-traumatic disorder [50]

Participants
Is post-traumatic headache different than other types of headaches?
Risk factors associated with post-traumatic headache
Treatment of post-traumatic headache
Psychological aspect of headache after traumatic brain injury
Challenges associated with studying post-traumatic headache
Findings
Conclusions
Full Text
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