Stacey Arthur, Lucas Sylvia, Dikmen Sureyya, Temkin Nancy, Bell Kathleen R, Brown Allen, Brunner Robert, Diaz-Arrastia Ramon, Watanabe Thomas K, Weintraub Alan, Hoffman Jeanne M
1 Department of Rehabilitation Medicine, University of Washington Medical Center , Seattle, Washington.
2 Department of Neurology, University of Washington , Seattle, Washington.
J Neurotrauma. 2017 Apr 15;34(8):1558-1564. doi: 10.1089/neu.2016.4721. Epub 2017 Jan 18.
Headache is one of the most frequently reported symptoms following traumatic brain injury (TBI). Little is known about how these headaches change over time. We describe the natural history of headache in individuals with moderate to severe TBI over 5 years after injury. A total of 316 patients were prospectively enrolled and followed at 3, 6, 12, and 60 months after injury. Individuals were 72% male, 73% white, and 55% injured in motor vehicle crashes, with an average age of 42. Pre-injury headache was reported in 17% of individuals. New or worse headache prevalence remained consistent with at least 33% at all time points. Incidence was >17% at all time points with first report of new or worse headache in 20% of participants at 60 months. Disability related to headache was high, with average headache pain (on 0-10 scale) ranging from 5.5 at baseline to 5.7 at 60 months post-injury, and reports of substantial impact on daily life across all time points. More than half of classifiable headaches matched the profile of migraine or probable migraine. Headache is a substantial problem after TBI. Results suggest that ongoing assessment and treatment of headache after TBI is needed, as this symptom may be a problem up to 5 years post-injury.
头痛是创伤性脑损伤（TBI）后最常报告的症状之一。关于这些头痛如何随时间变化，人们知之甚少。我们描述了中度至重度TBI患者伤后5年头痛的自然病程。共有316例患者在伤后3、6、12和60个月进行了前瞻性登记和随访。患者中72%为男性，73%为白人，55%在机动车事故中受伤，平均年龄42岁。17%的患者报告有伤前头痛。新出现或加重的头痛患病率在所有时间点均保持在至少33%。所有时间点的发病率均>17%，60个月时有20%的参与者首次报告新出现或加重的头痛。与头痛相关的残疾程度较高，平均头痛疼痛程度（0-10分制）从基线时的5.5分至伤后60个月时的5.7分，且在所有时间点均有对日常生活产生重大影响的报告。超过一半可分类的头痛符合偏头痛或可能偏头痛的特征。TBI后头痛是一个严重问题。结果表明，TBI后需要持续评估和治疗头痛，因为这种症状在伤后5年内都可能是个问题。
