TY - JOUR
T1 - Predictors of post-traumatic headache severity among deployed military personnel
AU - Bryan, Craig J.
AU - Hernandez, Ann M.
PY - 2011/6/1
Y1 - 2011/6/1
N2 - 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.
AB - 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.
KW - military population
KW - post-traumatic headache
KW - traumatic brain injury
UR - http://www.scopus.com/inward/record.url?scp=79958105034&partnerID=8YFLogxK
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U2 - 10.1111/j.1526-4610.2011.01887.x
DO - 10.1111/j.1526-4610.2011.01887.x
M3 - Article
C2 - 21457255
AN - SCOPUS:79958105034
VL - 51
SP - 945
EP - 953
JO - Headache
JF - Headache
SN - 0017-8748
IS - 6
ER -