Post-Concussive Syndrome: a Focus on Post-Traumatic Headache and Related Cognitive, Psychiatric, and Sleep Issues

• Published in: Current neurology and neuroscience reports Vol. 16; no. 11; p. 100
• Main Authors: Minen, Mia T, Boubour, Alexandra, Walia, Harjasleen, Barr, William
• Format: Journal Article Book Review
• Language: English
• Published: New York Springer US 01-11-2016; Springer Nature B.V
• Subjects: Anxiety; Cognition; Depressive Disorder; Headache (RB Halker; Humans; Medicine; Medicine & Public Health; Neurology; Neurosciences; Post-Traumatic Headache - diagnosis; Post-Traumatic Headache - physiopathology; Post-Traumatic Headache - therapy; Section Editor; Sleep Wake Disorders - etiology; Topical Collection on Headache; Cognitive changes; Post-traumatic headache (PTH) treatment; Sleep; Traumatic brain injury; Neuropsychiatry; Post-concussive syndrome (PCS); Post-traumatic headache (PTH)
• ISSN: 1528-4042; 1534-6293
• DOI: 10.1007/s11910-016-0697-7

Purpose of Review
Post-traumatic headache (PTH) is a secondary headache disorder following traumatic brain injury. We sought to examine the recent literature on PTH and associated cognitive, psychiatric, and sleep conditions to understand the latest findings about the associated conditions and available screening tools, and to understand the available treatment options for PTH.
Recent Findings
Up to one third of PTH patients may have depression and about one quarter may have insomnia. Anxiety and cognitive issues are also common. While there are few studies examining abortive medications for PTH, recent studies of preventive medications examine the efficacy of topiramate, and topiramate may be better than other oral preventive medications. Other currently investigated treatments include nerve blocks, onabotulinum toxin A, transmagnetic stimulation, and behavioral therapy (biofeedback).
Summary
Due to an expanded focus on and knowledge of concussion and PTH, comorbid psychiatric, cognitive, and sleep issues have become more widely acknowledged and studied. However, more high-quality studies must be conducted to examine the underlying pathophysiology of PTH and associated symptoms and to determine the most effective abortive and preventive treatment options.