Post Traumatic
Post Traumatic Headache Treatment
1. Acute post traumatic headaches with severe head injury
Post Traumatic Headache Diagnostic Criteria:
A. Headache, no typical characteristics known, fulfilling criteria C and D
B. Head trauma with at least one of the following:
1. loss of consciousness for >30 minutes
2. Glasgow Coma Scale (GCS) <13
3. post-traumatic amnesia for >48 hours
4. imaging demonstration of a traumatic brain lesion (cerebral haematoma, intracerebral and/or subarachnoid haemorrhage, brain contusion and/or skull fracture)
C. Headache develops within 7 days after head trauma or after regaining consciousness following head trauma
D. One or other of the following:
1. headache resolves within 3 months after head trauma
2. headache persists but 3 months have not yet passed since head trauma
2. Acute post traumatic headaches with mild head injury
Diagnostic criteria:
A. Headache, no typical characteristics known, fulfilling criteria C and D
B. Head trauma with all the following:
1. either no loss of consciousness, or loss of consciousness of <30 minutes’ duration
2. Glasgow Coma Scale (GCS) ≥13
3. symptoms and/or signs diagnostic of concussion
C. Headache develops within 7 days after head trauma
D. One or other of the following:
1. headache resolves within 3 months after head trauma
2. headache persists but 3 months have not yet passed since head trauma
Comment:
Mild head injury may give rise to a symptom complex of cognitive, behavioural and consciousness abnormalities and a GCS of ≥13. It can occur with or without abnormalities in the neurological examination, neuroimaging (CT scan, MRI), EEG, evoked potentials, CSF examination, vestibular function tests and neuropsychological testing. There is no evidence that an abnormality in any of these changes the prognosis or contributes to treatment. These studies should not be considered routine for patients with ongoing post-traumatic headache. They may be considered on a case-by-case basis, or for research purposes.
3. Chronic posttraumatic headaches with severe head injury
Diagnostic criteria:
A. Headache, no typical characteristics known, fulfilling criteria C and D
B. Head trauma with at least one of the following:
1. loss of consciousness for >30 minutes
2. Glasgow Coma Scale (GCS) <13
3. post-traumatic amnesia for >48 hours
4. imaging demonstration of a traumatic brain lesion (cerebral haematoma, intracerebral and/or subarachnoid haemorrhage, brain contusion and/or skull fracture)
C. Headache develops within 7 days after head trauma or after regaining consciousness following head trauma
D. Headache persists for >3 months after head trauma
4. Chronic posttraumatic headaches with mild to moderate head injury
Diagnostic criteria:
A. Headache, no typical characteristics known, fulfilling criteria C and D
B. Head trauma with all the following:
1. either no loss of consciousness, or loss of consciousness of <30 minutes’ duration
2. Glasgow Coma Scale (GCS) ≥13
3. symptoms and/or signs diagnostic of concussion
C. Headache develops within 7 days after head trauma
D. Headache persists for >3 months after head trauma
Comment:
Mild head injury may give rise to a symptom complex of cognitive, behavioural and consciousness abnormalities and a GCS of ≥13. It can occur with or without abnormalities in the neurological examination, neuroimaging (CT scan, MRI), EEG, evoked potentials, CSF examination, vestibular function tests and neuropsychological testing. There is no evidence that an abnormality in any of these changes the prognosis or contributes to treatment. These studies should not be considered routine for patients with ongoing post-traumatic headache. They may be considered on a case-by-case basis, or for research purposes.