Abstract
BackgroundHeadache is the most frequent symptom following head injury, but long-term follow-up of headache after head injury entails methodological challenges. In a population-based cohort study, we explored whether subjects hospitalized due to a head injury more often developed a new headache or experienced exacerbation of previously reported headache compared to the surrounding population.MethodsThis population-based historical cohort study included headache data from two large epidemiological surveys performed with an 11-year interval. This was linked with data from hospital records on exposure to head injury occurring between the health surveys. Participants in the surveys who had not been hospitalized because of a head injury comprised the control group. The head injuries were classified according to the Head Injury Severity Scale (HISS). Multinomial logistic regression was performed to investigate the association between head injury and new headache or exacerbation of pre-existing headache in a population with known pre-injury headache status, controlling for potential confounders.ResultsThe exposed group consisted of 294 individuals and the control group of 25,662 individuals. In multivariate analyses, adjusting for age, sex, anxiety, depression, education level, smoking and alcohol use, mild head injury increased the risk of new onset headache suffering (OR 1.74, 95% CI 1.05–2.87), stable headache suffering (OR 1.70, 95% CI 1.15–2.50) and exacerbation of previously reported headache (OR 1.93, 95% CI 1.24–3.02). The reference category was participants without headache in both surveys.ConclusionIndividuals hospitalized due to a head injury were more likely to have new onset and worsening of pre-existing headache and persistent headache, compared to the surrounding general population. The results support the entity of the ICHD-3 beta diagnosis “persistent headache attributed to traumatic injury to the head”.
Highlights
Headache is the most frequent symptom following head injury, but long-term follow-up of headache after head injury entails methodological challenges
In a previous population-based historical cohort study, which was based on the third wave of the NordTrøndelag Health Study (HUNT), we evaluated the relationship between previous head injury and headache phenotype [15]
The remaining 25,662 individuals were not hospitalized for head injury during this period
Summary
Headache is the most frequent symptom following head injury, but long-term follow-up of headache after head injury entails methodological challenges. There are, to our knowledge, only two other population-based, controlled studies on this subject and their findings are inconsistent [11, 12]. Both studies have methodological limitations [11, 12]. Headache prevalence and severity have been reported to be greater in those with mild head injury compared to those with more severe head injury [13, 14]. This inverse doseresponse relationship is paradoxical and needs further investigation
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
