Papers of the Week

Headache attributed to traumatic injury to the head (HAIH) is claimed to be the most common sequela following mild traumatic brain injury (MTBI), but epidemiological evidence is scarce. We explored whether patients with MTBI had an increase in headache suffering following injury compared to controls. We also studied predictors of headache. Trondheim MTBI follow-up study is a population-based, controlled, longitudinal study. We recruited patients exposed to MTBI and controls with minor orthopaedic injuries from a trauma-center and a municipal outpatient-clinic, and community controls from the surrounding population. Information on headache was collected through questionnaires at baseline, 3, and 12 months post-injury. We used a generalized linear mixed model to investigate the development of headache over time in the three groups, and logistic regression to identify predictors of headache. We included 378 patients exposed to MTBI, 82 trauma controls and 83 community controls. The MTBI-group had a larger increase in odds of headache from baseline to the first 3 months post-injury than the controls, but not from baseline to 3-12 months post-injury. Predictors for acute HAIH were female sex and pathological imaging findings on CT or MRI. Predictors for persistent HAIH were prior MTBI, being injured under the influence of alcohol, and acute HAIH. Patients who experience HAIH the first 3 months post-injury have good chances for improvement before reaching 12 months post-injury. Female sex, imaging findings on CT or MRI, prior MTBI and being injured under the influence of alcohol may predict exacerbation of headache.