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J Headache Pain. 2017 Dec;18(1):64. doi: 10.1186/s10194-017-0774-6. Epub 2017 Jun 26.

Post-traumatic headache in patients with minimal traumatic intracranial hemorrhage after traumatic brain injury: a retrospective matched case-control study.

Author information

1
Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, Seoul, 06273, Republic of Korea.
2
Severance Institute for Vascular and Metabolic Research, Yonsei University, Seoul, Republic of Korea.
3
Department of Neurosurgery, Inha University School of Medicine and Hospital, Incheon, Republic of Korea.
4
Department of Neurosurgery, Inje University Seoul Paik Hospital, Seoul, Republic of Korea.
5
Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, Seoul, 06273, Republic of Korea. ns.joonho.chung@gmail.com.
6
Severance Institute for Vascular and Metabolic Research, Yonsei University, Seoul, Republic of Korea. ns.joonho.chung@gmail.com.
7
Department of Neurological Surgery, Rush University Medical Center, 1725 W. Harrison St., Professional Building Suite 855, Chicago, IL, 60612, USA. ns.joonho.chung@gmail.com.

Abstract

BACKGROUND:

No evidence is available on the risks of neurologically asymptomatic minimal traumatic intracranial hemorrhage (mTIH) in patients with traumatic brain injury (TBI) for post-traumatic headache (PTH). The purpose of this study was to investigate whether mTIH in patients with TBI was associated with PTH and to evaluate its risk factors.

METHODS:

Between September 2009 and December 2014, 1484 patients with TBI were treated at our institution, 57 of whom had mTIH after TBI and were include in this study. We performed propensity score matching to establish a control group among the 823 patients with TBI treated during the same period. Patients with TBI rated their headaches prospectively using a numeric rating scale (NRS). We compared NRS scores between mTIH group (n = 57) and non-mTIH group (n = 57) and evaluated risk factors of moderate-to-severe PTH (NRS ≥ 4) at the 12-month follow-up.

RESULTS:

Moderate-to-severe PTH was reported by 21.9% of patients (29.8% in mTIH group and 14.0% in non-mTIH group B, p = 0.012) at the 12-month follow-up. The mean NRS was higher in mTIH group than in non-mTIH group throughout the follow-up period (95% confidence interval [CI], 0.11 to 1.14; p < 0.05, ANCOVA). Logistic regression analysis showed that post-traumatic seizure (odds ratio, 1.520; 95% CI, 1.128-6.785; p = 0.047) and mTIH (odds ratio, 2.194; 95% CI, 1.285-8.475; p = 0.039) were independently associated with moderate-to-severe PTH at the 12-month follow-up.

CONCLUSIONS:

Moderate-to-severe PTH can be expected after TBI in patients with mTIH and post-traumatic seizure. PTH occurs more frequently in patients with mTIH than in those without mTIH.

KEYWORDS:

Head trauma; Post-traumatic headache; Traumatic brain injury; Traumatic intracranial hemorrhage

PMID:
28653247
PMCID:
PMC5484651
DOI:
10.1186/s10194-017-0774-6
[Indexed for MEDLINE]
Free PMC Article

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