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

Robert L. Ruff, MD, PhD, et al.

Mild traumatic brain injury (TBI), also called concussion, is a common injury type among returning Operation Iraqi Freedom (OIF)/Operation Enduring Freedom (OEF) veterans. Headaches are the common pain consequence of TBI. However, little is known about the character of posttraumatic headaches in OIF/OEF veterans with mild TBI. We evaluated headache patterns among a group of 126 OIF/OEF veterans who reported suffering at least one concussion episode caused by exposure to an explosion. Eighty veterans had impairments on neurological examination or neuropsychological testing that we attributed to persisting TBI sequelae. The veterans with persisting deficits were more likely to have headaches, and their headaches, occurred more often and were more intense. This group of veterans was more likely to have posttraumatic stress disorder (PTSD) and impaired sleep with nightmares and reported being exposed to more explosions. We believe that PTSD and impaired sleep likely contribute to the increased frequency and severity of headaches among veterans with persisting deficits. We also believe that optimal treatment of these veterans is to treat all their problems rather than to focus on their headaches.

Volume 45 Number 7, 2008
   Pages 941 — 952

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