Post‐traumatic headache: An unmet medical need
Abstract
The degree of the unmet medical need in people with posttraumatic headache (PTH) is staggering. Most common in children and young people, traumatic brain injury is estimated to occur in at least 69 million people per year worldwide; and ~90% of these injuries are mild.1 Eighty percent of children and adolescents with mild traumatic brain injury report PTH acutely. In many children the headaches resolve quickly, but around 8% have PTH that persists beyond 3 months; half of whom have daily headache. Despite the considerable disease burden, there is limited evidence to guide the management of acute or chronic PTH, especially in children, as highlighted in the systematic review conducted by Patterson Gentile et al. in this issue.2 Careful assessment of the patient with PTH often provides essential information to help inform prognosis and guide management. It should include the consideration of poor prognostic preinjury factors including previous abuse, other pain disorders, and the presence of comorbidities such as preor postinjury sleep problems, neck pain, anxiety, and depression. Characterizing preinjury headaches can be very informative, paying attention to those commonly encountered in sport, for example, migraine induced by exercise, primary exercise headache, externalpressure headache, etc. Differentiating preinjury headaches from PTH can sometimes be challenging; especially as characteristics of PTH can change as they become chronic. There are several different PTH…
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