【社会人文】98%头部受伤的士兵遭遇头痛难题
Many soldiers experience head injury in combat and are likely to develop headaches, report researchers. The pain may be migrainelike and result in functional impairment.
These findings, released February 23, will be formally presented at the upcoming American Academy of Neurology's 61st Annual Meeting, in Seattle, Washington, to be held April 25 to May 2.
"Headaches are highly prevalent among soldiers with a history of mild traumatic head injury returning from Iraq or Afghanistan," lead investigator Brett Theeler, MD, from the Madigan Army Medical Center, in Tacoma, Washington, told Medscape Neurology & Neurosurgery.
"We were surprised by the percentage of headaches that had migraine-specific features," Dr. Theeler said. "We hope this study will help guide treatment and encourage physicians to assess returning soldiers for these features and treat accordingly."
Migraine-Specific Features
Mild traumatic brain injury is estimated to occur in 15% of soldiers. To assess the prevalence and characteristics of headaches following head injury, investigators conducted a cross-sectional, questionnaire-based study.
Soldiers had returned from Iraq or Afghanistan in the previous 3 months and were being evaluated at the Traumatic Brain Injury Program at Fort Lewis, in Washington.
Soldiers who had a concussion, head injury, or blast exposure while deployed were given a 13-item, self-administered headache questionnaire.
A total of 978 soldiers completed the headache questionnaire (95% response rate). The vast majority of respondents were male (98%), and the average age was 27.1 years.
The researchers found that most soldiers experienced headache in the past 3 months of deployment.
Headache Prevalence
Outcome Soldiers, n=978
Headache in past 3 months 957 (97.8%)
Mean frequency 8.4 d/mo
Mean severity 5.4 (out of 10)
Mean duration 4.4 h
Headaches started within 1 week of a concussion, head injury, or blast in 37% of soldiers. Another 20% experienced headache in 1 to 4 weeks of injury.
Among those whose headaches started within a week, 60% had pain with 3 or more migraine features. "This number is very high," Dr. Theeler emphasized during an interview, "and was much greater than we anticipated we might see."
Another 40% of soldiers had headaches that interfered with normal activities, and 30% experienced 15 or more headache days per month.
"Many unknowns remain regarding the management of posttraumatic headache," Dr. Theeler said. "This study suggests that we will need to work to better understand this in order to provide the best medical, emotional, and psychological support to returning soldiers."
This study was supported by the Comprehensive Neuroscience Program at the Uniformed Services University of the Health Sciences. Funding came from the Congressionally Directed Medical Research Programs.