Post-traumatic headache: epidemiology and pathophysiological insights

Håkan Ashina, Frank Porreca, Trent Anderson, Faisal Mohammad Amin, Messoud Ashina, Henrik Winther Schytz, David W. Dodick

Research output: Contribution to journalReview articlepeer-review

117 Scopus citations


Post-traumatic headache (PTH) is a highly disabling secondary headache disorder and one of the most common sequelae of mild traumatic brain injury, also known as concussion. Considerable overlap exists between PTH and common primary headache disorders. The most common PTH phenotypes are migraine-like headache and tension-type-like headache. A better understanding of the pathophysiological similarities and differences between primary headache disorders and PTH could uncover unique treatment targets for PTH. Although possible underlying mechanisms of PTH have been elucidated, a substantial void remains in our understanding, and further research is needed. In this Review, we describe the evidence from animal and human studies that indicates involvement of several potential mechanisms in the development and persistence of PTH. These mechanisms include impaired descending modulation, neurometabolic changes, neuroinflammation and activation of the trigeminal sensory system. Furthermore, we outline future research directions to establish biomarkers involved in progression from acute to persistent PTH, and we identify potential drug targets to prevent and treat persistent PTH.

Original languageEnglish (US)
Pages (from-to)607-617
Number of pages11
JournalNature Reviews Neurology
Issue number10
StatePublished - Oct 1 2019

ASJC Scopus subject areas

  • Clinical Neurology
  • Cellular and Molecular Neuroscience


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