• William C Walker, Ronald T Seel, Glenn Curtiss, and Deborah L Warden.
• Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA 23298-0661, USA. wcwalker@mail2.vcu.edu
• Arch Phys Med Rehabil. 2005 Sep 1; 86 (9): 1793-800.

ObjectivesTo measure longitudinally headache (HA) after moderate and severe traumatic brain injury (TBI) and to examine potential association with demographic, injury, and psychologic factors.DesignCohort study.SettingFour Veterans Administration rehabilitation facilities (Minneapolis, Palo Alto, Richmond, Tampa) within the Defense and Veterans Brain Injury Center.ParticipantsConsecutive patients (military or veteran beneficiaries) with moderate or severe TBI (N=109) who during acute rehabilitation consented to data collection and who completed 6- and 12-month follow-up evaluations.InterventionsNot applicable.Main Outcome MeasuresHA frequency, location, type, and incapacitation levels measured during prospective neurologic assessments.ResultsNearly 38% (41/109) of patients had acute posttraumatic headache (PTHA) symptoms; most often in a frontal location (20/41), most often of daily frequency (31/41), and showing no relation to injury severity, emotional, or demographic variables. Postacutely, PTHA symptom severity declined within the group. Better individual improvement was associated with less anxiety and depression at 6-month follow-up. Almost all subjects (21/22) with PTHA symptoms that persisted into the 6-month follow-up period reported symptoms again at 12-month follow-up.ConclusionsPTHA severity in this sample of persons with moderate and severe TBI showed a pattern of improvement that leveled off by 6 months posthospitalization.

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