Disability from posttraumatic headache is compounded by coexisting posttraumatic stress disorder

Abstract

Louise S Roper,1–3 Peter Nightingale,4 Zhangjie Su,5,6 James L Mitchell,1–3 Antonio Belli,5,6 Alexandra J Sinclair1–3 1Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, 2Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, 3Department of Neurology, 4Wolfson Computer Laboratory, University Hospital Birmingham NHS Foundation Trust, 5Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, 6Health Research Surgical Reconstruction and Microbiology Research Centre, Birmingham, UK Background: Posttraumatic headache (PTH) occurs in up to 82% of patients with traumatic brain injury (TBI). Posttraumatic stress disorder (PTSD) occurs in 39% of those with PTH. This study evaluates whether PTSD affects PTH disability. Methods: Eighty-six patients with TBI were prospectively evaluated in a secondary care trauma center. Headache disability was assessed using the Headache Impact Test version 6 and signs indicative of PTSD using the PTSD Check List Civilian version. Results: Increased PTSD-type symptoms were significantly associated with increased headache disability (p<0.001), as were employment status and loss of consciousness (p=0.049 and 0.016, respectively). Age was negatively correlated with headache disability (Spearman’s correlation rho=0.361, p=0.001). Conclusion: Increased severity of PTSD-type symptoms is significantly associated with increased headache disability in patients with chronic PTH. Managing PTSD symptoms in patients with chronic PTH may facilitate headache management. Keywords: chronic headache, traumatic brain injury, neurotrauma

Keywords

• Post-traumatic headache
• disability
• post-traumatic stress disorder
• traumatic brain injury
• neurotrauma