Department of Neurology, University of California, 505 Parnassus Avenue, Box 0114, San Francisco, CA 94143, USA.
Curr Pain Headache Rep. 2012 Dec;16(6):533-8. doi: 10.1007/s11916-012-0294-7.
Post-traumatic headache is a commonly described complication of traumatic brain injury. Recent studies highlight differences between headache features of combat veterans who suffered traumatic brain injury compared to civilians. Not surprisingly, there is a higher rate of associated PTSD and sleep disturbances among veterans. Factors of lower socioeconomic status, rank, and multiple head injuries appear to have a similar effect on post-traumatic headache in combat-related traumatic brain injury. Areas of discordance in the literature include the effect of prolonged loss of consciousness and the prevalence of specific headache phenotypes following head trauma. To date, there have been no randomized trials of treatment for post-traumatic headache. This may be related to the variability of headache features and uncertainty of pathophysiologic mechanisms. Given this lack of data, many practitioners follow treatment guidelines for primary headaches. Additionally, because of mounting data linking PTSD to post-traumatic headache in combat veterans, it may be crucial to choose multimodal agents and take a multidisciplinary approach to combat-related headache.
创伤性脑损伤后常出现头痛。近期研究突出了脑外伤退伍军人与平民头痛特征的差异。退伍军人中创伤后应激障碍和睡眠障碍的发生率更高，这并不奇怪。社会经济地位较低、军衔较低和多次头部受伤等因素似乎对与战斗相关的创伤性脑损伤后的创伤后头痛有类似的影响。文献中的不一致之处包括意识丧失时间延长和头部外伤后特定头痛表型的发生率。迄今为止，还没有针对创伤后头痛的随机试验。这可能与头痛特征的可变性和病理生理机制的不确定性有关。鉴于缺乏数据，许多从业者遵循原发性头痛的治疗指南。此外，由于越来越多的数据将创伤后应激障碍与战斗退伍军人的创伤后头痛联系起来，因此选择多模式药物并采用多学科方法治疗与战斗相关的头痛可能至关重要。
