William Beaumont Army Medical Center, Department of Medicine, Neurology Service, Medical Corps, United States Army, Fort Bliss, TX 79920-5001, USA.
Headache. 2010 Sep;50(8):1262-72. doi: 10.1111/j.1526-4610.2010.01700.x. Epub 2010 Jun 10.
To determine the prevalence, characteristics, impact, and treatment patterns of headaches after concussion in US Army soldiers returning from a deployment to Iraq or Afghanistan.
A cross-sectional study was conducted with a cohort of soldiers undergoing postdeployment evaluation during a 5-month period at the Madigan Traumatic Brain Injury Program at Ft. Lewis, WA. All soldiers screening positive for a deployment-related concussion were given a 13-item headache questionnaire.
A total of 1033 (19.6%) of 5270 returning soldiers met criteria for a deployment-related concussion. Among those with a concussion, 957 (97.8%) reported having headaches during the final 3 months of deployment. Posttraumatic headaches, defined as headaches beginning within 1 week after a concussion, were present in 361 (37%) soldiers. In total, 58% of posttraumatic headaches were classified as migraine. Posttraumatic headaches had a higher attack frequency than nontraumatic headaches, averaging 10 days per month. Chronic daily headache was present in 27% of soldiers with posttraumatic headache compared with 14% of soldiers with nontraumatic headache. Posttraumatic headaches interfered with duty performance in 37% of cases and caused more sick call visits compared with nontraumatic headache. In total, 78% of soldiers with posttraumatic headache used abortive medications, predominantly over-the-counter analgesics, and most perceived medication as effective.
More than 1 in 3 returning military troops who have sustained a deployment-related concussion have headaches that meet criteria for posttraumatic headache. Migraine is the predominant headache phenotype precipitated by a concussion during military deployment. Compared with headaches not directly attributable to head trauma, posttraumatic headaches are associated with a higher frequency of headache attacks and an increased prevalence of chronic daily headache.
确定从伊拉克或阿富汗部署返回的美国陆军士兵中脑震荡后头痛的患病率、特征、影响和治疗模式。
在华盛顿州刘易斯堡的 Madigan 创伤性脑损伤计划进行了一项横断面研究，对在 5 个月期间接受部署后评估的士兵队列进行了研究。对筛查出与部署相关的脑震荡呈阳性的所有士兵都进行了 13 项头痛问卷。
在 5270 名返回的士兵中，共有 1033 名（19.6%）符合与部署相关的脑震荡标准。在患有脑震荡的士兵中，有 957 名（97.8%）报告在部署的最后 3 个月中有头痛。创伤后头痛定义为脑震荡后 1 周内开始的头痛，在 361 名（37%）士兵中存在。总共，58%的创伤后头痛被归类为偏头痛。与非创伤性头痛相比，创伤后头痛的发作频率更高，平均每月 10 天。患有创伤后头痛的士兵中有 27%患有慢性每日头痛，而患有非创伤性头痛的士兵中有 14%患有慢性每日头痛。创伤后头痛在 37%的病例中干扰了值班表现，并导致比非创伤性头痛更多的病假就诊。总共，78%的创伤后头痛患者使用了中止药物，主要是非处方止痛药，大多数患者认为药物有效。
在因与部署相关而遭受脑震荡的返回军事人员中，超过 1/3 的人有符合创伤后头痛标准的头痛。偏头痛是在军事部署期间由脑震荡引发的主要头痛表型。与直接归因于头部创伤的头痛相比，创伤后头痛与更高的头痛发作频率和慢性每日头痛的患病率增加相关。
