Chronic Daily Headache in U.S. Soldiers After Concussion
Chronic Daily Headache in U.S. Soldiers After Concussion
The prevalence of CDH in U.S. soldiers after a deployment-related concussion is 20%, or 4− to 5-fold higher than that seen in the general population. CDH in soldiers with concussion usually has multiple features of migraine and frequently resembles chronic migraine. Onset of headaches within 1 week of a concussion is associated with the development of CDH as compared to episodic headache. Overuse of headache abortive medications, raising the possibility of MOH, occurs in half of soldiers with CDH. Blast exposure and multiple concussions are common in this population, but these factors are not specifically associated with CDH as compared to episodic headache. PTSD symptoms are strongly associated with CDH suggesting that traumatic stress may be a significant mediator of headache chronicity. These findings justify future studies examining strategies to prevent and treat CDH in military service members.
Conclusions
The prevalence of CDH in U.S. soldiers after a deployment-related concussion is 20%, or 4− to 5-fold higher than that seen in the general population. CDH in soldiers with concussion usually has multiple features of migraine and frequently resembles chronic migraine. Onset of headaches within 1 week of a concussion is associated with the development of CDH as compared to episodic headache. Overuse of headache abortive medications, raising the possibility of MOH, occurs in half of soldiers with CDH. Blast exposure and multiple concussions are common in this population, but these factors are not specifically associated with CDH as compared to episodic headache. PTSD symptoms are strongly associated with CDH suggesting that traumatic stress may be a significant mediator of headache chronicity. These findings justify future studies examining strategies to prevent and treat CDH in military service members.
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