Pre-TBI headache affects diagnosis of posttraumatic headache

Individuals with headache before traumatic brain injury (TBI) are less likely to receive a diagnosis of posttraumatic headache (PTH), according to a study published online May 20 in Headache.

Zachary Leibovit-Reiben, from the Mayo Clinic in Phoenix, and colleagues conducted an exploratory analysis of patients with TBI enrolled in a multicenter prospective, longitudinal patient registry (the American Registry for Migraine Research). A total of 2,717 patients were enrolled between Feb. 1, 2016, and May 6, 2020; 565 were included in this analysis. Patients with headaches prior to their TBI were compared to those without headaches prior to their TBI; 350 of 565 patients had headaches prior to their TBI.

The researchers found that although 25.7 percent of those with pre-TBI headache reported new or worsening headache within seven days of TBI, they were less likely to receive a diagnosis of PTH (4.0 versus 9.8 percent). Higher 12-item Allodynia Symptom Checklist scores, Migraine Attacks Subjective Cognitive Impairments Scale scores, and General Anxiety Disorder scores were seen for those with pre-TBI headache; they were also more likely to have a diagnosis of migraine (95.7 versus 89.3 percent).

“Those with preexisting headaches were less likely to receive a diagnosis of PTH, even though many of these patients reported new or worsening headaches within seven days of the TBI,” the authors write. “This underdiagnosis has potential implications for treatment, especially once there are PTH-specific therapies available.”

Several authors disclosed financial ties to the biopharmaceutical industry.

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