Volume 45 Number 7, 2008
   Pages 941 — 952

Abstract - Headaches among Operation Iraqi Freedom/Operation Enduring Freedom veterans with mild traumatic brain injury associated with exposures to explosions

Robert L. Ruff, MD, PhD;1-2* Suzanne S. Ruff, PhD;3 Xiao-Feng Wang, PhD4

1Neurology Service and Polytrauma System of Care, Louis Stokes Cleveland Department of Veterans Affairs Medical Center (VAMC), Cleveland, OH; 2Department of Neurology, Case Western Reserve University, Cleveland, OH; 3Psychology Service and Polytrauma System of Care, Louis Stokes Cleveland VAMC, Cleveland, OH; 4Department of Quantitative Health Sciences, The Cleveland Clinic, Cleveland, OH

Abstract — Traumatic brain injury (TBI) is a common injury type among Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans, and headaches are a frequent consequence of TBI. We examined the hypothesis that among veterans who reported mild TBI caused by exposure to an explosion during deployment in OIF/OEF, those with residual neurocognitive deficits would have a higher frequency of headaches and more severe headaches. We evaluated 155 consecutive veterans with neurological examination and neuropsychological testing. We excluded 29 veterans because they did not have mild TBI or they did not complete the evaluation. We analyzed headache pattern, intensity, and frequency. Among the 126 veterans studied, 80 had impairments on neurological examination or neuropsychological testing that were best attributed to TBI. Veterans with impairments had been exposed to more explosions and were more likely to have headache, features of migraine, more severe pain, more frequent headaches, posttraumatic stress disorder, and impaired sleep with nightmares.

Key words: blast, combat, explosion, headache, migraine, OEF, OIF, pain, sleep, traumatic brain injury.

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