In a past blog post, we explained the four main types of post-traumatic headaches (PTH) and discussed the basic principles associated with them. The International headache Society identifies two main types of headaches—primary and secondary. Primary headaches are idiopathic and far more common, whereas secondary headaches typically have an identifiable underlying cause and may not resolve until it is diagnosed and addressed. This week we wanted to create a deeper understanding of this complex secondary headache by illuminating the most up to date prognostic and diagnostic factors of PTH.

PTHs and migraine headaches have many similar characteristics but are distinguishable based on their temporal relationship to trauma. When a headache arises within seven days of a traumatic event to the head or neck, or within seven days after a person regains consciousness after trauma, it is classified as a PTH. PTHs are among the most common secondary headache disorders, being categorized as acute if lasting less than three months and chronic if lasting longer.

According to the International Classification of Headache Disorders 3 (beta version), several factors contribute to the development of PTH including genes, psychopathology and even patient’s expectations of developing headache after injury. Factors influencing the duration and extent of recovery may include premorbid intellectual status, presence of litigation, socioeconomic status, and any mental health comorbidities.

Given the number of potential predispositions and exacerbating factors, it is essential that treating or testifying experts examine the patient’s history of headaches prior to the traumatic injury. This evaluation will determine if there have been any marked changes in the pattern or presentation of the pre-existing headache(s). If the headache has attributes of any of the primary headaches and is exacerbated by the traumatic event (two-fold or greater), it will maintain its primary diagnosis and also be secondarily classified as a PTH.

To learn more about PTH look here.