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The Contribution of Injury Mechanism to the Phenotype of Posttraumatic Headache

Don McGeary, PhD (University of Texas Health Science Center- San Antonio, San Antonio, TX, United States); Cindy McGeary, PhD; Blessen C. Eapen, MD; Carlos Jaramillo, MD, PhD

Meeting: AAPM&R Annual Assembly 2019

Session Information

Date: Saturday, November 16, 2019

Session Title: Spine and Pain Research Report

Session Time: 11:15am-12:45pm

Location: Research Hub - Kiosk 7

Disclosures: Don McGeary, PhD: Nothing to disclose

Objective: Demonstrate differences in symptom patterns among Veterans with posttraumatic headache who sustained head injury through mechanical injury and blast exposure.

Design : Three-arm RCT

Setting: VA Polytrauma Rehabilitation Center in South Texas Veterans Health Care System

Participants: 240 Veterans with persistent posttraumatic headaches and comorbid posttraumatic stress disorder who participated in a large, VA/DoD funded, prospective randomized clinical trial of non-pharmacological interventions for posttraumatic headache.

Interventions: This study used a three-arm randomized clinical trial format for which participants were randomly assigned into one of three intervention arms as follows: 1. Eight-session manualized nonpharmacological intervention for headache 2. Twelve-session manualized nonpharmacological intervention for PTSD 3. Usual Care in VA Polytrauma Clinic

Main Outcome Measures: Headache Impact Score-6 (six-item self-report measure of headache-related disability); Structured Diagnostic Interview for Headache (clinician-guided interview describing headache symptoms/phenotype); Headache Diary (frequency, duration, severity); NIH Toolbox Cognitive Assessment (memory, concentration, attention)

Results: Baseline assessment data from a large, federally-funded clinical trial shows differences in the manifestation of headache after head injuries of different mechanisms (e.g., more severe and disabling headache in blast exposed compared to mechanical injury).

Conclusions: Veterans with blast exposure experience posttraumatic headache that is phenotypically distinct from those with mechanical injury to the head or neck (e.g., fall, blunt trauma to the head). These findings suggest differential treatment response between these two groups that may indicate the need for tailored treatments targeting posttraumatic headache of different origins.

Level of Evidence: Level I

To cite this abstract in AMA style:

McGeary D, McGeary C, Eapen BC, Jaramillo C. The Contribution of Injury Mechanism to the Phenotype of Posttraumatic Headache [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/the-contribution-of-injury-mechanism-to-the-phenotype-of-posttraumatic-headache/. Accessed May 18, 2025.
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