According to a recent 2017 study published in The Journal of Headache and Pain, post-traumatic headache occurs more frequently in patients with minimal traumatic intracranial haemorrhage (mTIH) than in those without mTIH.

Post-traumatic headache refers to headache that occurs within one week after head trauma. It results in patients with traumatic brain injury (TBI) with neurologically asymptomatic mTIH. A post-traumatic headache (PTH) may affect the quality of life of the patient and its known to be linked with other issues such as depression, cognitive dysfunction, and insomnia.

Currently, no evidence is available indicating the risks of neurologically asymptomatic mTIH in patients with TBI for a PTH.

Therefore, a retrospective case-control study from a prospectively collected database was conducted to investigate the association between TIH in TBI patients with PTH and find out its risk factors.

The study included 57 patients who had mTIH after TBI from 1484 patients with TBI, treated between September 2009 and December 2014 in Yonsei University College of Medicine, Korea. Propensity score was matched to establish a control group among the 823 patients with TBI treated during the same period. Patients with TBI used numeric rating scale (NRS) to rate their headaches prospectively. The NRS scores were compared between mTIH group (n=57) and non-mTIH group (n=57). The risk factors of moderate-to-severe PTH (NRS≥4) was also evaluated at the 12-month follow-up.

The results revealed that moderate-to-severe PTH was reported by 21.9% of patients (29.8% in mTIH group and 14.0% in non-mTIH group B, p=0.012) at the 12-month follow-up. The mean score of NRS was found to be higher in mTIH group compared to non-mTIH group throughout the follow-up period (95% confidence interval [CI], 0.11 to 1.14; p<0.05, ANCOVA). Logistic regression analysis estimated independent association of post-traumatic seizure (odds ratio, 1.520; 95% CI, 1.128–6.785; p=0.047) and mTIH (odds ratio, 2.194; 95% CI, 1.285–8.475; p=0.039) with moderate-to-severe PTH at the 12-month follow-up.

Overall, the study analyzed that moderate-to-severe PTH can be expected after TBI in patients with mTIH and post-traumatic seizure. It was estimated that PTH occurs more frequently in patients with mTIH than in those without mTIH.