scholarly journals Greater Severity and Functional Impact of Post-Traumatic Headache in Veterans with Comorbid Neck Pain following Traumatic Brain Injury

2020 ◽  
Author(s):  
Bahar Shahidi ◽  
Robyn W Bursch ◽  
Jennifer S Carmel ◽  
Ashleigh C Carranza ◽  
Kelsey M Cooper ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Neck Pain ◽  
Psychosocial Functioning ◽  
Bodily Pain ◽  
Functional Impact ◽  
Role Function ◽  
Emotional Role ◽  
Post Traumatic ◽  
The Impact

Purpose/Hypothesis: Traumatic brain injury (TBI) affects 1.7 million people in the U.S. annually, the majority being mild in severity (mTBI). Post-traumatic headache (PTH) is one of the most common symptoms experienced after mTBI caused by head or neck trauma and is often refractory to treatment. Although military Veterans commonly experience mTBI after blast or blunt injuries that likely affect musculoskeletal structures in the neck, the prevalence of cervical symptoms in Veterans with PTH following mTBI have not been well characterized. Similarly, the impact of comorbid neck pain on physical and psychosocial functioning in this population is unknown. This study aims to assess the prevalence of neck pain in Veterans with PTH following mTBI, and to compare the severity and functional impact of PTH between those with and without comorbid neck pain. Number of Subjects: 33 Veterans with PTH after a military-related mTBI were identified from a secondary analysis of data from a prior study. Materials and Methods: Participants were determined to have PTH if they responded to questions on the Patient Headache History Questionnaire (PHHQ), attributed PTH to an accident or injury, and reported PTH in the TBI history. Individuals with both PTH and comorbid neck pain (PTH+NP) were identified based on an affirmative response to one or more questions on the PHHQ indicating that HA episodes were either preceded or accompanied by neck pain. Standardized measures of HA severity and frequency, insomnia, fatigue, mood disorders (Depression, Anxiety, and Posttraumatic Stress Disorder), and physical and emotional role function (SF-36) were compared between groups with and without comorbid neck pain. Results: Of the 33 participants with PTH, 22 (67%) also had neck pain. There were no differences in demographic or TBI-specific characteristics between groups (p>0.069). Sixty-three percent of the PTH+NP group reported severe or incapacitating HA, compared to 27% of those with PTH alone (P=0.049). Insomnia severity and fatigue were significantly greater in the PTH+NP group (P<0.040), and physical function due to bodily pain and physical role function was significantly lower in the PTH+NP group (P<0.036). There were no significant differences between groups for any of the mood or emotional-role functioning scales (P>0.326). Conclusions: The majority of Veterans with mTBI and PTH reported comorbid neck pain. Veterans with PTH and NP reported increased severity of HA, insomnia, fatigue, and a greater physical, but not emotional functional limitations compared to those without NP.

scholarly journals Greater Severity and Functional Impact of Post-traumatic Headache in Veterans With Comorbid Neck Pain Following Traumatic Brain Injury

2020 ◽  
Author(s):  
Bahar Shahidi ◽  
Robyn W Bursch ◽  
Jennifer S Carmel ◽  
Ashleigh C Carranza ◽  
Kelsey M Cooper ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Neck Pain ◽  
Physical Functioning ◽  
Bodily Pain ◽  
Blunt Injury ◽  
Convenience Sample ◽  
Emotional Role ◽  
Physical Limitations ◽  
Post Traumatic

ABSTRACT Background Post-traumatic headache (PTH) is a commonly experienced symptom after mild traumatic brain injury (mTBI). Blast injury– or blunt injury–related mechanisms for mTBI in veterans can also affect musculoskeletal structures in the neck, resulting in comorbid neck pain (NP). However, it is unknown whether the presence of comorbid NP may be associated with a different pattern of headache symptoms, physical functioning, or emotional functioning compared to those without comorbid NP. The purpose of this study is to examine the role of comorbid NP in veterans with mTBI and PTH. Design and Methods This was a cross-sectional investigation of an existing dataset that included 33 veterans who met inclusion criteria for PTH after mTBI. Standardized measures of headache severity and frequency, insomnia, fatigue, mood disorders, and physical and emotional role function were compared between groups with and without comorbid NP. Results The majority of participants with PTH reported comorbid NP (n = 22/33, 67%). Those with comorbid NP experienced more headache symptoms that were severe or incapacitating, as compared to mild or moderate for those without NP (φ = 0.343, P = .049); however, no differences in headache frequency (φ = 0.231, P = .231) or duration (φ = 0.129, P = .712) were observed. Participants with comorbid NP also reported greater insomnia (d = 1.16, P = .003) and fatigue (d = 0.868, P = .040) as well as lower physical functioning (d = 0.802, P = .036) and greater bodily pain (d = 0.762, P = .012). There were no differences in anxiety, depression, mental health, emotional role limitations, vitality, or social functioning between those with and without comorbid NP (d ≤ 0.656, P ≥ .079). Conclusions A majority of veterans with mTBI and PTH in our sample reported comorbid NP that was associated with greater headache symptom severity and physical limitations, but not with mood or emotional limitations. Preliminary findings from this small convenience sample indicate that routine assessment of comorbid NP and associated physical limitations should be considered in veterans with mTBI and PTH.

PTSD and Traumatic Brain Injury

2018 ◽  
Author(s):  
Richard A. Bryant
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Stress Responses ◽  
Post Traumatic Stress ◽  
Postconcussive Syndrome ◽  
Post Traumatic ◽  
Explosive Devices ◽  
The Impact ◽  
Distinctive Role

One of the more hotly debated issues in the field of post-traumatic stress disorder (PTSD) is the role of traumatic brain injury (TBI), and particularly mild traumatic brain injury (mTBI). This topic became increasingly the focus of attention in the context of recent wars in Iraq and Afghanistan, where many troops suffered PTSD and mTBIs. Over three-quarters of injuries sustained in these conflicts arose from encounters with explosive devices, and accordingly it was often claimed that the “signature injuries” of the wars in Iraq and Afghanistan were both PTSD and mTBI. Clinicians and researchers have thus given renewed attention to the interplay of these two conditions. This chapter reviews definitional issues of PTSD and mTBI, how PTSD can develop after mTBI, the impact mTBI may have on stress responses, the distinctive role of postconcussive syndrome, and how to manage PTSD following mTBI.

scholarly journals Misdiagnosis of post-traumatic stress disorder following severe traumatic brain injury

2005 ◽  
Vol 186 (5) ◽  
pp. 423-426 ◽  
Author(s):  
Ruth E. Sumpter ◽  
Tom M. McMillan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Structured Interview ◽  
Self Report ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
The Impact

BackgroundThe incidence of post-traumatic stress disorder (PTSD) after traumatic brain injury is unclear. One issue involves the validity of diagnosis using self-report questionnaires.AimsTo compare PTSD ‘caseness' arising from questionnaire self-report and structured interview.MethodParticipants (n=34) with traumatic brain injury were recruited. Screening measures and self-report questionnaires were administered, followed by the structured interview.ResultsUsing questionnaires, 59% fulfilled criteria for PTSD on the Post-traumatic Diagnostic Scale and 44% on the Impact of Events Scale, whereas using structured interview (Clinician-Administered PTSD Scale) only 3% were ‘cases'. This discrepancy may arise from confusions between effects of PTSD and traumatic brain injury.ConclusionsAfter traumatic brain injury, PTSD self-report measures might be used for screening but not diagnosis.

The impact of prophylactic treatment on post-traumatic epilepsy after severe traumatic brain injury

Brain Injury ◽  
2007 ◽  
Vol 21 (5) ◽  
pp. 499-504 ◽  
Author(s):  
R. Formisano ◽  
C. Barba ◽  
M. G. Buzzi ◽  
J. Newcomb-Fernandez ◽  
F. Menniti-Ippolito ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Prophylactic Treatment ◽  
Post Traumatic ◽  
Post Traumatic Epilepsy ◽  
The Impact ◽  
Traumatic Epilepsy

THE IMPACT OF SEX ON NEUROPSYCHIATRIC SYMPTOMS IN OLDER ADULTS POST TRAUMATIC BRAIN INJURY

2020 ◽  
Vol 28 (4) ◽  
pp. S101
Author(s):  
Jahnavi Mundluru ◽  
Abdul Subhan ◽  
Tsz Lo ◽  
Luis Fornazzari ◽  
David Munoz ◽  
...  
Keyword(s):  
Older Adults ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Neuropsychiatric Symptoms ◽  
Post Traumatic ◽  
The Impact

Time Interval Between Traumatic Brain Injury And Post Traumatic Epilepsy

2013 ◽  
Vol 21 (2) ◽  
pp. 222-228
Author(s):  
Daniel Garbin Di Luca ◽  
Glenda Corrêa Borges de Lacerda
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
First Year ◽  
Time Interval ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Post Traumatic ◽  
Faster Development ◽  
Post Traumatic Epilepsy ◽  
Traumatic Epilepsy

Introduction. The estimated time interval in which an individual can develop Post Traumatic Epilepsy (PTE) after a traumatic brain injury (TBI) is not clear. Objective. To assess the possible influence of the clinical features in the time interval between TBI and PTE develop­ment. Method. We analyzed retrospectively 400 medical records from a tertiary Brazilian hospital. We selected and reevaluated 50 patients and data was confronted with the time between TBI and PTE devel­opment by a Kaplan-Meier survival analysis. A Cox-hazard regression was also conducted to define the characteristics that could be involved in the latent period of the PTE development. Results. Patients devel­oped PTE especially in the first year (56%). We found a tendency of a faster development of PTE in patients older than 24 years (P<0.0001) and in men (P=0.03). Complex partial seizures evolving to generalized seizures were predominant in patients after moderate (37.7%) and severe (48.8%) TBIs, and simple partial seizures evolving to general­ized seizures in mild TBIs (45.5%). Conclusions. Our data suggest that the first year after a TBI is the most critical period for PTE de­velopment and those males older than 24 years could have a faster development of PTE.

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