Lee Matthew J, Zhou Yi, Greenwald Brian D
Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA.
JFK Johnson Rehabilitation Institute, Edison, NJ 08820, USA.
Brain Sci. 2022 Oct 6;12(10):1357. doi: 10.3390/brainsci12101357.
Post-traumatic headache (PTH) is the most common sequelae of traumatic brain injury (TBI). Its phenotypic variability, absence of formal evidence-based guidelines for treatment and underdiagnosis have made its management a challenge for clinicians. As a result, treatment of PTH has been mostly empiric. Although analgesics are the most popular drug of choice for PTH, they can present with several adverse effects and fail to address other psychosocial comorbidities associated with TBI. Non-pharmacological interventions thereby offer an intriguing alternative that can provide patients with PTH sustainable and effective care. This review article aims to: (1) provide an update on and describe different non-pharmacological interventions present in the recent literature; (2) provide clinical guidance to providers struggling with the management of patients with PTH; (3) emphasize the need for more high-quality trials examining the effectiveness of non-pharmacological treatments in patients with PTH. This review discusses 21 unique non-pharmacological treatments used for the management of PTH. Current knowledge of non-pharmacological interventions for the treatment of PTH is based on smaller scale studies, highlighting the need for larger randomized controlled trials to help establish formal evidence-based guidelines.
创伤后头痛(PTH)是创伤性脑损伤(TBI)最常见的后遗症。其表型变异性、缺乏基于循证的正规治疗指南以及诊断不足,使得临床医生对其治疗颇具挑战。因此,PTH的治疗大多基于经验。尽管镇痛药是治疗PTH最常用的药物选择,但它们可能会出现多种不良反应,且无法解决与TBI相关的其他心理社会合并症。非药物干预因此提供了一种有趣的替代方法,可以为PTH患者提供可持续且有效的护理。这篇综述文章旨在:(1)更新并描述近期文献中存在的不同非药物干预措施;(2)为在PTH患者管理方面存在困难的医疗人员提供临床指导;(3)强调需要更多高质量试验来检验非药物治疗对PTH患者的有效性。本综述讨论了用于管理PTH的21种独特的非药物治疗方法。目前关于PTH非药物干预的知识基于规模较小的研究,这凸显了开展更大规模随机对照试验以帮助制定正规循证指南的必要性。