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Predictors of Post‐Traumatic Headache Severity Among Deployed Military Personnel
Author(s) -
Bryan Craig J.,
Hernandez Ann M.
Publication year - 2011
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/j.1526-4610.2011.01887.x
Subject(s) - traumatic brain injury , medicine , neurocognitive , observational study , military personnel , injury prevention , poisson regression , illness severity , psychiatry , physical therapy , poison control , severity of illness , emergency medicine , population , cognition , environmental health , political science , law
( Headache 2011;51:945‐953) Objective.— The current study used a cross‐sectional observational design to evaluate the relationship between psychological, physiological, and contextual factors and headache severity among 133 deployed military personnel and 4 civilian contractors diagnosed with mild traumatic brain injury (mTBI) referred to a combat support hospital in Iraq. Background.— Although TBI and headache sequelae have been documented for military combatants, little is known about factors associated with headache severity. Methods.— Military personnel (n = 157) and civilian (n = 4) contractors referred to a combat support hospital in Iraq underwent a standardized intake evaluation which included computerized neurocognitive testing, psychological and physical health questionnaires, a clinical interview, and a physical examination by a physician. Results.— Results of zero‐inflated Poisson regression modeling suggest that insomnia is associated with increased likelihood for endorsement of any headache, but loss of consciousness, post‐traumatic stress disorder symptoms, and slowed reaction time only are predictive of headache severity. Among the subset of patients presenting to the combat support hospital within 7 days of mTBI (n = 101), number of TBI symptoms demonstrated a non‐significant trend toward increased likelihood of headache endorsement of any kind, with loss of consciousness, post‐traumatic stress disorder, and slowed reaction time demonstrating significant relationships with headache severity. Conclusion.— Knowledge of predictors of post‐concussive headache onset and severity may assist clinicians in making important decisions regarding treatment recommendations for veterans with mTBI.