• Håkan Ashina, Rune H Christensen, Haidar Muhsen Al-Khazali, Afrim Iljazi, Daniel Tolnai, Anna K Eigenbrodt, LarssonHenrik B WHBWFunctional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine, and PET, Rigshospitalet - Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Henrik W Schytz, Ulrich Lindberg, and AminFaisal MohammadFMDepartment of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark. faisal@dadlnet.dk.Department of Brain and Spinal Cord Injury, Copenhagen University Hospital - Rigshospitalet, Cope.
• Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
• J Headache Pain. 2023 Feb 24; 24 (1): 1515.

ObjectiveTo examine whether white matter hyperintensities (WMHs) and cerebral microbleeds (CMBs) are more prevalent in people with persistent post-traumatic headache attributed to mild traumatic brain injury (TBI), compared with healthy controls.MethodsA magnetic resonance imaging (MRI) study of adults with persistent post-traumatic headache attributed to mild TBI and age- and gender-matched healthy controls. A semi-structured interview and validated self-report instruments were used to record data on demographics, clinical characteristics, and comorbidities. Imaging data were obtained on a 3T MRI Scanner using a 32-channel head coil. Participants and controls underwent a single MRI session, in which fluid-attenuated inversion recovery was used to visualize WMHs, and susceptibility-weighted imaging was used to detect CMBs. The primary outcomes were (I) the difference in the mean number of WMHs between participants with persistent post-traumatic headache and healthy controls and (II) the difference in the mean number of CMBs between participants with persistent post-traumatic headache and healthy controls. All images were examined by a certified neuroradiologist who was blinded to the group status of the participants and controls.ResultsA total of 97 participants with persistent post-traumatic headache and 96 age- and gender-matched healthy controls provided imaging data eligible for analyses. Among 97 participants with persistent post-traumatic headache, 43 (44.3%) participants presented with ≥ 1 WMH, and 3 (3.1%) participants presented with ≥ 1 CMB. Compared with controls, no differences were found in the mean number of WMHs (2.7 vs. 2.1, P = 0.58) and the mean number of CMBs (0.03 vs. 0.04, P = 0.98).ConclusionsWMHs and CMBs were not more prevalent in people with persistent post-traumatic headache than observed in healthy controls. Future studies should focus on other MRI techniques to identify radiologic biomarkers of post-traumatic headache.© 2023. The Author(s).

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