“ Compared with headaches not directly attributable to head trauma, post-traumatic headaches are associated with a higher frequency of headache attacks and an increased prevalence of chronic daily headache,” wrote Dr. Erickson and his colleagues.
There are a number of ways soldiers can develop post-traumatic headaches— both combat-related and otherwise.
“ Head injuries in service members can be related to combat— shrapnel and fragments, bullets, explosions, etc.— but also to falls and motor vehicle accidents,” says Ann I. Scher, PhD, associate professor of epidemiology at Uniformed Services University in Bethesda, Md.“ There is a lot of interest right now in blastrelated injuries, including repeated mild injuries.”
Scher is currently involved in a study at Fort Carson and Fort Bragg in which she and her colleagues are measuring headache symptoms in soldiers returning from deployment in Iraq or Afghanistan. The research team found that most soldiers— regardless of whether they experienced a TBI— reported headaches after returning home. However, migraine was more common in soldiers who had a TBI.
“ We are doing a follow-up study in which we will be studying their headache symptoms more carefully and will also be following them for one year to see how they do,” she says.
DIAGNOSIS AND TREATMENT
The symptoms of TBI vary depending on a number of factors— namely the severity of the injury and how much time has lapsed since the injury, Dr. Erickson says. Headaches are among the most common symptoms of TBI. Other symptoms include dizziness, difficulty with memory and concentration, sleep problems and mood changes.
It’ s important that soldiers— particularly veterans— learn to recognize these symptoms, Dr. Erickson says. Although it might be easy to downplay the seriousness of headaches or delay treatment, doing so opens the
If you’ re a soldier looking for help, visit the NHF War Veterans Resource Initiative at www. headaches. org / warveterans.
Know Your TBI
Mild TBI
Characterized by a confused state lasting less than 24 hours, memory loss lasting less than 24 hours and a loss of consciousness lasting less than 30 minutes.
Severe TBI
Characterized by a confused state lasting more than 24 hours, a loss of consciousness lasting more than 24 hours and memory loss lasting more than seven days.
Source: The Armed Forces Health Surveillance Center
door to potential complications, such as chronic headaches, insomnia, depression and anxiety.
For deployed soldiers who suffer a potentially concussive event, the military conducts a medical evaluation as soon as possible. Soldiers also have TBI screenings when they return from deployment and when they enter the Veterans Affairs system, according to Dr. Erickson. If a soldier meets the criteria for TBI, one major goal of the treatment regimen is to avoid a repeat event.
“ A rare but potentially fatal complication is secondimpact syndrome, which occurs when someone has another concussion before they have fully recovered from the initial concussion,” Dr. Erickson says.
For a successsful recovery, military service members need a treatment regimen that includes medications for headaches, nausea, sleep difficulties and mood changes; plenty of rest; and a gradual return to regular activities. Migraine medications may also be necessary for those who develop chronic headaches, Dr. Erickson says.
Regardless of whether the headaches are chronic or less frequent, the important thing is to get them treated as soon as possible. With all of the resources available, soldiers and veterans don’ t have to suffer their pain alone. HW
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