Pharmacological Treatment of Persistent Post-Traumatic Headache and Factors Contributing to Outcome – Retrospective Study
Olivia FT Scott, Goldin Joghataie, Artee Srivastava, Asma Mushtaque, Ella Huszti, Qixuan Li, Dina Safarini, Timothy Butson, Charles H Tator, M Carmela TartagliaObjective
Persistent post traumatic headache (PTH) is a common sequalae of concussion. There is a lack of research on real world pharmacological treatment. This study aims to evaluate the effectiveness of prophylactic medication for PTH in a clinical environment.
Methods
This study is a retrospective chart review of patients referred to a tertiary care center. We compared effectiveness of standard headache prophylactic therapies in PTH.
Results
Headache improvement was 64 % after first medication and 79% after all medications. For first line therapy, the most improvement was treatment with Gabapentin (73.3%). The odds of headache improvement from MVC were 3.8 times higher for Gabapentin compared to Amitriptyline/Nortriptyline.
Conclusion
PTH may be improved by prophylactic migraine medication. Targeted therapies particularly gabapentin in concussions following motor vehicle accidents support the broader concept that PTH is responsive to preventive treatment strategies. However, the small sample size and retrospective design limit the ability to draw definite treatment-specific conclusions.