Post-traumatic headache attributed to traumatic brain injury: classification, clinical characteristics, and treatment

Håkan Ashina, Anna K Eigenbrodt, Tad Seifert, Alexandra J Sinclair, Ann I Scher, Henrik W Schytz, Mi Ji Lee, Roberto De Icco, Alan G Finkel, Messoud Ashina

Research output: Contribution to journalReview articlepeer-review


Post-traumatic headache is a common sequela of traumatic brain injury and is classified as a secondary headache disorder. In the past 10 years, considerable progress has been made to better understand the clinical features of this disorder, generating momentum to identify effective therapies. Post-traumatic headache is increasingly being recognised as a heterogeneous headache disorder, with patients often classified into subphenotypes that might be more responsive to specific therapies. Such considerations are not accounted for in three iterations of diagnostic criteria published by the International Headache Society. The scarcity of evidence-based approaches has left clinicians to choose therapies on the basis of the primary headache phenotype (eg, migraine and tension-type headache) and that are most compatible with the clinical picture. A concerted effort is needed to address these shortcomings and should include large prospective cohort studies as well as randomised controlled trials. This approach, in turn, will result in better disease characterisation and availability of evidence-based treatment options.

Original languageEnglish
Pages (from-to)460-469
Number of pages10
JournalThe Lancet Neurology
Issue number6
Publication statusPublished - Jun 2021


  • Brain Injuries/complications
  • Brain Injuries, Traumatic/classification
  • Disease Progression
  • Headache
  • Headache Disorders
  • Headache Disorders, Secondary/classification
  • Humans
  • Migraine Disorders
  • Post-Traumatic Headache/classification
  • Prospective Studies
  • Tension-Type Headache


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