Addressing chronic persistent headaches after MTBI as a neuropathic pain state

J Headache Pain. 2020 Jun 19;21(1):77. doi: 10.1186/s10194-020-01133-2.

Abstract

An increasing number of patients with chronic persistent post-traumatic headache (PPTH) after mild traumatic brain injury (MTBI) are being referred to headache or pain specialists as conventional treatment options for primary headache disorders have not been able to adequately alleviate their debilitating headache symptoms. Evolving clinical and mechanistic evidences support the notation that chronic persistent MTBI related headaches (MTBI-HA) carry the hallmark characteristics of neuropathic pain. Thus, in addition to conventional treatment options applicable to non-traumatic primary headache disorders, other available treatment modalities for neuropathic pain should be considered. In this comprehensive review article, the author reveals the prevalence of MTBI-HA and its clinical manifestation, discusses existing clinical and mechanistic evidence supporting the classification of chronic persistent MTBI-HA as a neuropathic pain state, and explores current available treatment options and future directions of therapeutic research related to MTBI-HA.

Keywords: Chronic mild TBI related headaches; Chronic persistent post-traumatic brain injury headache; MTBI; MTBI-HA; Mild traumatic brain injury; Neuropathic pain state; PPTH; Persistent post-traumatic headaches.

Publication types

  • Review

MeSH terms

  • Brain Concussion / diagnosis*
  • Brain Concussion / epidemiology*
  • Brain Concussion / therapy
  • Headache Disorders / diagnosis*
  • Headache Disorders / epidemiology*
  • Headache Disorders / therapy
  • Humans
  • Neuralgia / diagnosis*
  • Neuralgia / epidemiology*
  • Neuralgia / therapy
  • Prevalence