216 Headache Medicine, v.2, n.4, p.216, Oct./Nov./Dec. 2011
Chronic post-traumatic headache after mild brain injury
(Abstract)
Cefaleia pós-traumática crônica após traumatismo cranioencefálico leve (Resumo)
Introduction:Introduction:
Introduction:Introduction:
Introduction: Post-traumatic headache (PTH) is the most
common symptom found in the post-traumatic syndrome, it
starts within seven days after the trauma, the acute form of it
lasts until three months and the chronic form persists after this
period. The evaluation of patients with PTH remains a great
challenge to clinicians due to the lack of objective findings,
so there is always controversy if the symptoms are real,
psychogenic or "produced". Due to the similarity of the clinical
expression of chronic PTH (cPTH) with practically all forms of
primary headache, it was the objective of this study to determine
the occurrence of events that frequently arise in patients of
these groups: depression, anxiety, poor quality of life and
cutaneous allodynia (CA).
Methodology: Methodology:
Methodology: Methodology:
Methodology: The subjects were divided in three
groups: (a) one group without headache (CONTROL, n=25),
in the 14-84 age group, mean of 35 years old (b) chronic
post-traumatic headache (cPTH, n=19), in the 11-70 age
group, mean of 34 years old and (c) migraine (MIGRAINE,
n=29), in the 13-59 age group, mean of 36 years old, with
no significant statistical difference among the groups when
related to age. The patients were assessed in relation to the
present symptoms of anxiety and depression by the Beck's
Anxiety Inventory (BAI) and Beck's Depression Inventory (BDI),
respectively. The Quality of Life Inventory was also applied,
analyzing the four functional quadrants (affection, social, health
and professional). In the quantitative evaluation of CA the
esthesiometer of Semmens-Weinstein was used for the thresholds
of pressure, and glass test tubes for the evaluation of thermal
sensitivity. In relation to the qualitative evaluation of CA, it
was used a simplified questionnaire.
Results:Results:
Results:Results:
Results: The majority of patients with cPTH showed similar
headache symptoms to the migraine ones. The PTH was
associated to the anxiety and depression levels, which are
similar to the group with migraine and superior to the control
group (p<0.001). The quality of life of the patients with PTH
was similar to the migraine and inferior to the control group
Hugo André de Lima Martins
Universidade Federal de Pernambuco. Pós-graduação em Neuropsiquiatria e Ciências do Comportamento
(área de concentração: Neurologia). PhD Thesis. 2010. Orientador: Marcelo Moraes Valença
Martins HAL. Chronic post-traumatic headache after mild brain injury (Abstract).
Headache Medicine. 2011;2(4): 216
Correspondence
Hugo André de Lima MartinsHugo André de Lima Martins
Hugo André de Lima MartinsHugo André de Lima Martins
Hugo André de Lima Martins
hugomt2001@yahoo.com.br
THESISTHESIS
THESISTHESIS
THESIS
in all quadrants, (p<0.05). The thresholds of thermal and
mechanical sensitivity were inferior in the cPTH in relation to
the control group, (p<0.05). Patients with PTH showed a larger
quantity of cephalic allodynic symptoms and extra-cephalic
in relation to the control group in the evaluation by a simplified
questionnaire, (p<0.05).
Conclusion:Conclusion:
Conclusion:Conclusion:
Conclusion: The cPTH presents similar clinical
characteristics to migraine. Patients with cPTH present high
levels of symptoms of anxiety and depression and reduced
level of life quality. The patients with cPTH showed reduced
thresholds of thermal and mechanical sensitivity and larger
quantity of allodynic symptoms in relation to the control group
and similar to the migraine group.
