Headaches are a well-known symptom of traumatic brain injuries and concussions, but common knowledge would suggest these headaches usually last a week or a month at most. New research suggests these headaches may be more severe and last much longer than most people would think.
According to findings recently presented at the American Headache Society (AHS) 58th Annual Scientific Meeting, people who have experienced a traumatic brain injury face a high risk of persistent headaches for at least 5 years after their injury.
The researchers involved in the study from the University of Washington Medical Center, Seattle, say patients with TBI are as much as five times more likely to experience headaches and that the severity of headaches remained consistent during the 5 years of follow-up in the study.
“Headaches after [TBI] should not be written off,” Sylvia Lucas, MD, Ph.D., clinical professor at the University of Washington Medical Center, Seattle, and lead author of the study, commented in a release. “This study sheds light on education needed among primary care providers and other practitioners caring for those suffering from [TBI].”
She added: “The frequency, intensity and impact on daily functioning should be recorded to better treat headaches. Suffering from intense headaches after an injury shouldn’t be the only option.”
For the study, the researchers prospectively studied 216 individuals who were admitted to inpatient rehabilitation after experiencing a moderate to severe TBI. The team gathered information about each participant’s history of headaches, as well as the prevalence, frequency, classification, pain rating, and effect of new headaches compared to those before their injury.
Out of the participants, 72% were men, 73% were white, and the average age was 42. The most common cause of brain injury in the study was vehicle accidents.
According to the findings, the data collected showed participants had a high prevalence of new or worsening headaches that lasted throughout the course of the study.
The level of pain from these headaches also stayed consistent through the study. On a 0 to 10 scale, the pain level stayed between 5.5 and 5.7. In addition to this, the headaches caused significant impairment to study participants.
While the severity of the headaches stayed consistent, the frequency of did decline throughout the study. At 3 months after injury, half of the participants experienced headaches several times per week or daily, but that fell to 36% by the end of the study.
According to the researchers, it is difficult to compare the prevalence of headaches found in this study to an estimate of headaches among the general population since it is difficult to assess the prevalence of headaches experienced by the public. However, Lucas said that moderate to severe headaches are experienced by significantly fewer people than in those with traumatic brain injury.
Lucas also stated that it is not possible to identify what is causing these long-term headaches, “because we have a deplorable lack of basic science knowledge of what goes on in [TBIs].”
She continued, “My own personal opinion is that there’s going to be some overlap between the headache you get from [TBI] and the headache you get if you were born with the migraine gene, because sometimes when we ask folks to explain what their headaches are like, they are very similar.”
Ultimately, Dr. Lucas feels this is just the start of their research. “I feel that our study is kind of step 1: Who gets it, what do they get, how long does it last?”
“Step 2 is going to be much more difficult, and that is: How can we treat these? We have no evidence-based medicines as of yet, so we’re all treating these headaches by the seat of our pants.
“We’re using the same drug for a migraine-like headache after a brain injury as we use for a migraine headache as a primary headache, so that’s a tall order, but that’s what people are trying to do now,” she concluded.