Characterization of persistent post-traumatic headache and management strategies in adolescents and young adults following mild traumatic brain injury

• Published in: Scientific reports Vol. 12; no. 1; p. 2209
• Main Authors: Kothari, Simple Futarmal, Eggertsen, Peter Preben, Frederiksen, Oana Veronica, Thastum, Mille Moeller, Svendsen, Susanne Wulff, Tuborgh, Astrid, Næss-Schmidt, Erhard Trillingsgaard, Rask, Charlotte Ulrikka, Schröder, Andreas, Kasch, Helge, Nielsen, Jørgen Feldbæk
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 09-02-2022; Nature Publishing Group; Nature Portfolio
• Subjects: 692/1807; 692/308; 692/617; Adolescent; Adult; Analgesics; Analgesics - therapeutic use; Brain Concussion - complications; Brain Concussion - epidemiology; Disease management; Female; Headache; Headaches; Humanities and Social Sciences; Humans; Male; Migraine; Migraine Disorders - epidemiology; Migraine Disorders - etiology; multidisciplinary; Parathyroid hormone; Phenotypes; Post-Traumatic Headache - epidemiology; Post-Traumatic Headache - etiology; Post-Traumatic Headache - therapy; Science; Science (multidisciplinary); Self-Management - methods; Tension-Type Headache - epidemiology; Tension-Type Headache - etiology; Traumatic brain injury; Young Adult; Young adults
• DOI: 10.1038/s41598-022-05187-x
• EISSN: 2045-2322

Characteristics of persistent post-traumatic headache (PTH) in young individuals are poorly known leading to diagnostic problems and diverse management. We aimed to describe headache phenotypes and self-reported management strategies in young individuals with PTH following mild traumatic brain injury (mTBI). A comprehensive structured questionnaire was used to evaluate headache phenotypes/characteristics and management strategies to relieve headache in 107, 15–30-year-old individuals with PTH. Around 4 months post-injury, migraine-like headache in combination with tension-type like headache (40%) was the most commonly encountered headache phenotype followed by migraine-like headache (36%). Around 50% reported aura-like symptoms before/during the headache attack. Medication-overuse headache was diagnosed in 10%. Stress, sleep disturbances, and bright lights were the most common trigger factors. More than 80% reported that their headache was worsened by work-related activity and alleviated by rest/lying down. Simple analgesics were commonly used (88%) whereas prophylactic drugs were rarely used (5%). Bedrest and physiotherapy were also commonly used as management strategies by 56% and 34% of the participants, respectively. In conclusion, most young individuals with PTH after mTBI presented with combined migraine-like and tension-type-like headache followed by migraine-like headache, only. Preventive headache medication was rarely used, while simple analgesics and bedrest were commonly used for short-term headache relief.