Magazine article Clinical Psychiatry News

Postconcussion Headache Lingers in Soldiers

Magazine article Clinical Psychiatry News

Postconcussion Headache Lingers in Soldiers

Article excerpt

LOS ANGELES - Postconcussion headache in soldiers can persist for up to a decade, according to two studies of Iraq and Afghanistan veterans who sustained combat-related traumatic brain injury.

In one study, nearly all soldiers who returned from deployment during which they sustained a concussion reported headache a year later. One in five reported chronic daily headache. In the other study, most veterans 5-8 years out from traumatic brain injury had headache, with no difference from those 1-4 years out. About half had severe headache.

Dr. Sarah K. Gibbons of Madigan Healthcare System, Tacoma, Wash., and colleagues studied 181 soldiers with deployment-related concussion who completed questionnaires at baseline and 1 year later. The prevalence of headache in the past 3 months was 92% at baseline and 98% at 1 year (P = .08). Corresponding prevalence of chronic daily headache was 26% and 18%. "When you consider that 4%-6% of the general population suffers from chronic daily headache, this is clinically significant," Dr. Gibbons said.

The average Migraine Disability Assessment score rose from 5.5 at baseline to 11 at 1 year (P less than .03). Overall, 70% had no improvement in headache frequency (less than a 50% decrease) or a worsening during the study period. Fully 84% were on medication for headache abortive purposes at 1 year, and 12% were on migraine prophylactic medication. The mean number of acute headache medication-days per month was 6. …

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