Predictors of post-traumatic headache severity among deployed military personnel

Craig J. Bryan, Ann M. Hernandez

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Objective.- The current study used a cross-sectional observational design to evaluate the relationship between psychological, physiological, and contextual factors and headache severity among 133 deployed military personnel and 4 civilian contractors diagnosed with mild traumatic brain injury (mTBI) referred to a combat support hospital in Iraq. Background.- Although TBI and headache sequelae have been documented for military combatants, little is known about factors associated with headache severity. Methods.- Military personnel (n = 157) and civilian (n = 4) contractors referred to a combat support hospital in Iraq underwent a standardized intake evaluation which included computerized neurocognitive testing, psychological and physical health questionnaires, a clinical interview, and a physical examination by a physician. Results.- Results of zero-inflated Poisson regression modeling suggest that insomnia is associated with increased likelihood for endorsement of any headache, but loss of consciousness, post-traumatic stress disorder symptoms, and slowed reaction time only are predictive of headache severity. Among the subset of patients presenting to the combat support hospital within 7 days of mTBI (n = 101), number of TBI symptoms demonstrated a non-significant trend toward increased likelihood of headache endorsement of any kind, with loss of consciousness, post-traumatic stress disorder, and slowed reaction time demonstrating significant relationships with headache severity. Conclusion.- Knowledge of predictors of post-concussive headache onset and severity may assist clinicians in making important decisions regarding treatment recommendations for veterans with mTBI.

Original languageEnglish (US)
Pages (from-to)945-953
Number of pages9
Issue number6
StatePublished - Jun 1 2011


  • military population
  • post-traumatic headache
  • traumatic brain injury

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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