School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, BT7 1NN Belfast, UK.
J Integr Neurosci. 2021 Dec 30;20(4):1079-1094. doi: 10.31083/j.jin2004109.
Traumatic brain injury is a common and major cause of disability and death that might require emergency neurological and neurosurgical interventions. Traumatic brain injury can result in temporary or permanent physical, cognitive and psychological impairments. One of the most common complications associated with traumatic brain injury is post-traumatic headache, associated with significant disability and reduced quality of life. Post-traumatic headache is a public health concern that can affect the long-term outcome of traumatic brain injury patients. Clinical symptoms of post-traumatic headache significantly overlap with common primary headaches such as migraine and tension-type headaches. Beyond neurobiological factors, psychological factors can play crucial roles in the initiation and sustainment of post-traumatic headache. While neurological mechanisms underlying post-traumatic headache remains unknown, different studies suggest various mechanisms such as physical damages to the cranial nerves and neck structure, hyper-sensitization of the pain modulatory pathway, and inflammation as underlying causes for the neurobiology of headache. I explore the hypothesis that traumatic brain injury is associated with headaches. In particular, I provide an overview of the neurobiology of post-traumatic headache, its diagnosis, presenting recent findings on the etiology, explaining similarities and differences between with primary headaches such as migraine and tension-type headache, discuss pharmacological and non-pharmacological interventions for the treatments, as well as emphasising on the psychological importance of post-traumatic headache.
创伤性脑损伤是一种常见且主要的致残和致死原因,可能需要紧急神经学和神经外科学干预。创伤性脑损伤可导致暂时或永久性的身体、认知和心理损伤。与创伤性脑损伤相关的最常见并发症之一是创伤后头痛,其与显著的残疾和生活质量下降有关。创伤后头痛是一个公共卫生问题,会影响创伤性脑损伤患者的长期预后。创伤后头痛的临床症状与常见的原发性头痛(如偏头痛和紧张型头痛)有明显重叠。除了神经生物学因素外,心理因素在创伤后头痛的发生和持续中也起着至关重要的作用。尽管创伤后头痛的神经生物学机制尚不清楚,但不同的研究表明,颅神经和颈部结构的物理损伤、疼痛调节途径的超敏反应以及炎症等多种机制可能是头痛的潜在原因。我探讨了创伤性脑损伤与头痛之间存在关联的假设。特别是,我概述了创伤后头痛的神经生物学、其诊断、目前关于病因的研究结果,解释了其与偏头痛和紧张型头痛等原发性头痛之间的相似之处和差异,讨论了治疗创伤后头痛的药物和非药物干预措施,并强调了创伤后头痛的心理重要性。