Kjeldgaard Dorte, Forchhammer Hysse, Teasdale Tom, Jensen Rigmor H
Danish Headache Center, University of Copenhagen, Denmark.
Cephalalgia. 2014 Mar;34(3):191-200. doi: 10.1177/0333102413505236. Epub 2013 Sep 17.
The aetiology behind chronic post-traumatic headache (CPTH) after mild head injury is unclear and management is complicated. In order to optimize treatment strategies we aimed to characterize a CPTH population.
Ninety patients with CPTH and 45 patients with chronic primary headaches were enrolled from the Danish Headache Center. All patients were interviewed about demographic and headache data. They completed the Harvard Trauma Questionnaire (HTQ), Rivermead Post Concussion Symptoms Questionnaire, SF-36 and a headache diary.
The CPTH group experienced more cognitive ( P < 0.001) and somatic symptoms ( P = 0.048) and rated their self-perceived health as more affected in terms of physical function ( P = 0.036), physical role function ( P = 0.012) and social function ( P = 0.012) than the control group. Surprisingly, 31% of the CPTH group had a score equal to or above the cut-off score for having post-traumatic stress disorder (PTSD) according to the HTQ. In terms of demographics and headache, the groups were comparable except the CPTH group were more often without affiliation to the labour market ( P < 0.001).
The loss of work capacity and high levels of disability for the CPTH patients suggests directions for further research into what important factors are embedded in the patients' PTSD symptoms and might explain their prolonged illness.
轻度头部损伤后慢性创伤后头痛（CPTH）的病因尚不清楚，治疗也很复杂。为了优化治疗策略，我们旨在对CPTH患者群体进行特征描述。
从丹麦头痛中心招募了90例CPTH患者和45例慢性原发性头痛患者。所有患者均接受了关于人口统计学和头痛数据的访谈。他们完成了哈佛创伤问卷（HTQ）、里弗米德脑震荡后症状问卷、SF-36和头痛日记。
与对照组相比，CPTH组经历了更多的认知症状（P<0.001）和躯体症状（P=0.048），并认为其自我感知健康在身体功能（P=0.036）、身体角色功能（P=0.012）和社会功能（P=0.012）方面受到的影响更大。令人惊讶的是，根据HTQ，31%的CPTH组患者的得分等于或高于创伤后应激障碍（PTSD）的临界值。在人口统计学和头痛方面，除了CPTH组更常与劳动力市场无关外（P<0.001），两组具有可比性。
CPTH患者工作能力丧失和残疾程度高，这为进一步研究患者PTSD症状中包含哪些重要因素以及可能解释其病程延长的原因指明了方向。
