What are the other Names for this Condition? (Also known as/Synonyms)

• Persistent Headache Attributed to Traumatic Head Injury
• Persistent Headache due to Traumatic Head Injury
• Persistent Headache due to Traumatic Injury to the Head

What is Persistent Headache Attributed to Traumatic Injury to the Head? (Definition/Background Information)

• Persistent Headache Attributed to Traumatic Injury to the Head may be described as a form of secondary headache disorder that develops within a week’s time of the traumatic injury and lasts for 3 months or more in duration. Since the underlying cause is known, the term “secondary” is used
• Based on the severity of the injury, Persistent Headache Attributed to Traumatic Injury to the Head is grouped as:
  • Persistent Headache Attributed to Moderate or Severe Traumatic Injury to the Head
  • Persistent Headache Attributed to Mild Traumatic Injury to the Head
• The head injury may be on account of a traumatic road (vehicle) accident, fall injury, gunshot wound, stab (penetrating) injury, or sports-related injury arising from the action of an external contact force on the head
• Individuals of any age group, gender, race, or ethnicity may be at risk for Persistent Headache Attributed to Traumatic Injury to the Head

The criteria for diagnosis of Persistent Headache Attributed to Traumatic Injury to the Head as outlined by the International Headache Society (IHS) is given below:

• Traumatic injury to the head has occurred
• Any headache fulfilling the criteria below
• Headache is reported to have developed within 7 days after one of the following:
  • The injury to the head
  • Regaining of consciousness following the injury to the head
  • Discontinuation of medication(s) impairing ability to sense or report headache following the injury to the head
• Headache persists for over 3 months after its onset
• Not better accounted for by another ICHD-3 diagnosis

In addition to satisfying all of the above, the specific criteria for mild, moderate, or severe traumatic head injury are as follows:

For Persistent Headache Attributed to Moderate or Severe Traumatic Injury to the Head - injury to the head associated with at least one of the following:

• Loss of consciousness for over 30 minutes
• Glasgow Coma Scale (GCS) score less than 13
• Post-traumatic amnesia lasting over 24 hours
• Alteration in level of awareness for over 24 hours
• Imaging evidence of a traumatic head injury such as skull fracture, intracranial hemorrhage and/or brain contusion

For Persistent Headache Attributed to Mild Traumatic Injury to the Head - Injury to the head fulfilling both of the following criteria:

Associated with none of the following:

• Loss of consciousness for over 30 minutes
• Glasgow Coma Scale (GCS) score less than 13
• Post-traumatic amnesia lasting over 24 hours
• Alteration in level of awareness for over 24 hours
• Imaging evidence of a traumatic head injury such as skull fracture, intracranial hemorrhage and/or brain contusion

Associated with one or more of the following symptoms and/or signs:

• Transient confusion, disorientation or impaired consciousness
• Loss of memory for events immediately before or after the head injury
• Two or more of the following symptoms suggestive of mild traumatic brain injury:
  • Nausea
  • Vomiting
  • Visual disturbances
  • Dizziness and/or vertigo
  • Gait and/or postural imbalance
  • Impaired memory and/or concentration.

(Source: International Headache Society Classification ICHD-3, London, United Kingdom)

Differential diagnosis: It is important to exclude medication-overuse headache prior to establishing a diagnosis of Persistent Headache Attributed to Traumatic Injury to the Head.