Introduction

Traumatic brain injury (TBI) is one of the most significant public health concerns worldwide, affecting millions of people each year and leading to varying degrees of physical, cognitive, and psychological impairments.1 This injury results from a direct or indirect impact on the head, often caused by motor vehicle accidents, falls, physical assaults, sports-related injuries, and industrial accidents. Based on severity, TBI is classified into mild, moderate, and severe categories, each with different clinical outcomes.2 While many individuals with mild TBI recover within a short period, others may experience long-term or even permanent complications. Given its high prevalence and wide-ranging consequences, a comprehensive investigation into the clinical and epidemiological effects of TBI is essential.3

Patients with TBI present with a broad spectrum of symptoms and complications that vary in severity and duration depending on the extent and location of the injury. Some of the most common issues include cognitive impairments such as reduced concentration, memory deficits, and slower information processing, as well as mood disturbances like depression, anxiety, and irritability. Additionally, patients may experience motor dysfunctions, including poor coordination, dizziness, and balance problems, along with sleep disturbances and chronic pain. These symptoms not only disrupt daily life but also significantly impair social and occupational functioning.4

One of the most prevalent and debilitating complications of TBI is post-traumatic headache (PTH). Despite its high prevalence and significant impact on daily functioning and quality of life, PTH remains a complex and poorly understood condition. Post-traumatic headache (PTH) is a secondary headache disorder that occurs as a consequence of traumatic brain injury (TBI) and is diagnosed primarily based on clinical criteria. According to the International Classification of Headache Disorders (ICHD-3), acute PTH is defined as a headache that develops within 7 days following the trauma or regaining consciousness. In individuals with a pre-existing headache disorder, the diagnosis of PTH requires a significant worsening of the headache temporally related to the trauma. While most acute cases resolve spontaneously, persistent PTH is diagnosed when the headache continues beyond three months post-injury. This condition can lead to substantial functional impairment and often coexists with other post-TBI symptoms, making accurate identification and classification essential for research and clinical care.5 Moreover, a considerable number of individuals continue to experience headaches even a year after the injury, highlighting the chronic nature of this condition.6 PTH typically develops within the first few weeks following the injury but, in some cases, can become chronic and persist for months or even years. Clinically, it can present in different forms, including tension-type headaches, migraines, headaches associated with increased intracranial pressure, and neuropathic headaches. Several mechanisms contribute to its development, such as cranial nerve damage, inflammation from the injury, alterations in cerebral blood flow, and disruptions in central pain processing systems. Additionally, psychological factors, including stress and emotional distress following TBI, can intensify both the severity and duration of headaches.7

PTH has a profound impact on both the physical and mental health of patients. This condition not only reduces quality of life but also leads to sleep disturbances, impaired concentration, increased irritability, and emotional problems such as depression and anxiety. Furthermore, persistent headaches can interfere with daily activities, decrease work productivity, and impose substantial healthcare costs.8 Many patients resort to long-term use of painkillers to manage their headaches, which may result in drug dependence and complications from medication overuse. Therefore, gaining a better understanding of the factors contributing to PTH and developing effective treatment strategies is crucial in reducing the burden of this condition and improving patient outcomes.9

Given the high prevalence and serious consequences of PTH in TBI patients, accurately estimating its occurrence is of great importance. A systematic review and meta-analysis of existing studies can provide a clearer understanding of prevalence rates, patterns of occurrence, and associated factors. These findings will not only help guide clinical decision-making in the treatment and management of affected individuals but also serve as a foundation for healthcare policies and preventive strategies. Therefore, this study aims to systematically assess the prevalence of PTH to provide precise and comprehensive data that can facilitate future research and enhance patient care.

Methods

This systematic review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Search Strategy

Relevant articles on the prevalence of post-traumatic headache (PTH) were retrieved from four English databases—Scopus, PubMed, Embase, and Web of Science—covering the period from January 2000 to December 2024. The search was conducted using the following keywords: “Traumatic Brain Injury”, “TBI”, “mTBI”, “mild TBI”, “Head Injury”, “Brain Trauma”, “Chronic Headache(s)”, “Persistent Headache(s)”, “Long-term Headache(s)”, and “Headache(s)”. Titles and abstracts of the retrieved articles were screened to assess eligibility. Irrelevant studies were excluded, and the full texts of the remaining articles were independently reviewed by two authors. Additionally, the references of the selected articles were manually searched to identify further relevant studies.

Inclusion/Exclusion Criteria

The inclusion criteria were as follows: studies published in English between 2000 and 2024, observational studies involving adult patients with traumatic brain injury (TBI), and studies reporting essential data, such as the frequency or prevalence of headaches in these individuals. Studies conducted on other age groups, as well as reviews, qualitative studies, editorials, and interventional studies, were excluded from the analysis. Additionally, studies with a sample size of fewer than 100 participants and those with incomplete or insufficient data were also excluded.

Data Extraction and Quality Assessment

Data were independently extracted by two researchers from the eligible studies, with any disagreements resolved through discussion. The collected data included the first author’s name, year of publication, sample size, study location (country and continent), measurement scale, follow-up duration, headache severity, target population, methodological quality score, and headache prevalence.

Quality Assessment

For methodological quality assessment, the Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to evaluate cross-sectional studies. Two independent reviewers assessed each study across key domains, including sample selection, measurement validity, confounding factors, and statistical analysis. Each study was rated based on the JBI criteria, with higher scores reflecting stronger methodological quality. Disagreements were resolved through discussion or consultation with a third reviewer. Studies meeting ≥70% of the criteria were classified as high quality, while those meeting 50–69% were considered moderate quality. The quality assessment results were incorporated into the subgroup analysis to determine whether study quality influenced the pooled prevalence estimates.10

Data Analysis

Statistical analysis was conducted using Stata software version 17. To assess heterogeneity among studies, Cochran’s Q test and the I² statistic were applied. Heterogeneity was considered significant if the p-value was below 0.05 or if I² exceeded 50%. In cases of low heterogeneity, a fixed-effects model was used to estimate the overall prevalence, whereas a random-effects model was applied when substantial heterogeneity was detected. To explore potential sources of heterogeneity, subgroup analysis, sensitivity analysis, and meta-regression were performed. Subgroup analysis examined prevalence differences based on factors such as continent, target population (military vs non-military), headache assessment tools, follow-up duration (<1 year, >1 year, unspecified), sample size (<1,000 vs >1,000 participants), and methodological quality of the studies. Sensitivity analysis assessed the impact of excluding individual studies on overall results. Meta-regression was conducted to investigate factors influencing heterogeneity, including mean patient age and year of publication. To assess publication bias, a funnel plot was used to visually inspect data symmetry, and Egger’s test was performed to detect potential bias in the included studies.

Results Selection Results and Study Characteristics

In the initial search, 4,422 articles were retrieved, of which 2,508 were duplicates. Titles and abstracts were then screened, leading to the exclusion of 1,400 studies due to not meeting the inclusion criteria or being irrelevant. The full texts of 503 studies were reviewed independently by two authors. As a result, 27 studies were excluded due to a sample size of fewer than 100 participants, 396 studies due to insufficient data, and 17 studies due to being conducted on children. Ultimately, 63 studies were included in the final analysis (see Figure 1).

Figure 1 The PRISMA flowchart. Adapted from Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. doi:10.1136/bmj.n71.11

The smallest and largest sample sizes were 100,12,13 and 102,05514 respectively. Most studies were published in 2022 (n = 8) and 2012 (n = 7). Also, 62% of selected studies were conducted in USA. The rest of the studies were related to the countries of Colombia (n = 1), Japan (n = 1), Taiwan (n = 1), Finland (n = 1), Denmark (n = 2), Norway (n = 3), Korea (n = 1), Netherlands (n = 1), China (n = 1), France (n = 1), Sweden (n = 1), Canada (n = 2), Ireland (n = 1) and Australia (n = 1). Of the included studies, 13 were classified as having moderate methodological quality, while the remaining studies were of high quality. These classifications were based on the Joanna Briggs Institute (JBI) Critical Appraisal Checklist, considering factors such as sample selection, measurement validity, confounding factors, and statistical analysis (Table 1).

Table 1 The Characteristics of the Included Papers

The pooled prevalence of posttraumatic headache was 49.3% (95% CI: 44.7–53.9%). Sensitivity analysis showed that removing any single study did not significantly affect the overall prevalence of headache. This finding indicates that the meta-analysis results are stable and not influenced by any specific study.

Subgroup Analysis

Subgroup analysis showed that the prevalence of headache in studies with sample sizes of less than 1000 and more than 1000 participants was 50.4% (95% CI: 45.7–55.2%) and 42.1% (95% CI: 26.8–57.4%), respectively (p = 0.308). The analysis by continent revealed that the prevalence of headache in studies conducted in Asia, Europe, and America was 42.3% (95% CI: 27.5–57%), 48.9% (95% CI: 39.2–58.5%), and 51.4% (45.5–57.2%), respectively, with no significant difference between these three regions (p = 0.515).

Regarding measurement tools, the highest prevalence of headache was reported in studies using interviews (65.2%, 95% CI: 55.9–74.6%), while the lowest prevalence was observed in studies utilizing the NRS (25.2%, 95% CI: 6.7–43.7%) (p < 0.001). The prevalence of headache varied significantly across different measurement scales (p<0.001). In 64 studies, headache was assessed up to one year after trauma, whereas in 12 studies, it was examined beyond one year. The prevalence of headache in one-year and more-than-one-year follow-ups was 45.4% (95% CI: 40.5–50.3%) and 58.3% (95% CI: 42.8–73.8%), respectively (p = 0.005). The prevalence of headache was 45.1% (95% CI: 40.7–49.6%) in the general patient population and 56.1% (95% CI: 46.7–65.3%) in the military population, with significant difference between the two groups (p = 0.039). Additionally, the prevalence of headache in studies with high and moderate methodological quality was largely similar (48.2%, 95% CI: 43.3–53.1 vs 56%, 95% CI: 43.1–69%) (p = 0.270) (Table 2).

Table 2 The Results of the Subgroup Analysis

Meta-Regression

The meta-regression results indicated that the pooled prevalence of posttraumatic headache was not influenced by the year of publication (p = 0.345), sample size (p = 0.502), or the mean age of patients (p = 0.219). In other words, variations in these factors did not lead to a significant difference in the reported prevalence of headache across studies.

Publication Bias

The results showed that Egger’s test did not provide evidence of publication bias (p = 0.375). In addition, a funnel plot was used for visual assessment. Therefore, the meta-analysis results were not affected by selective publication of studies.

Discussion

The findings of this systematic review and meta-analysis showed that the prevalence of posttraumatic headache (PTH) is 49.3% (95% CI: 44.7–53.9%). This high prevalence highlights PTH as one of the most common and debilitating complications of traumatic brain injury (TBI), with potential long-term effects on patients’ physical and mental health. Given the potential for PTH to become chronic and persist for more than a year, accurately estimating its prevalence and patterns is essential for effective treatment and prevention strategies.19 Our findings are similar to previous findings. Our findings are comparable to those of some previous studies. For example, in another meta-analysis conducted in 2008, the prevalence of post-traumatic headache (PTH) among veterans and civilians was reported to be 57.8%. This study found that the prevalence of PTH in patients with mild traumatic brain injury (75.3%) was unexpectedly higher than in those with moderate/severe traumatic brain injury (32.1%). Several factors may contribute to this difference in prevalence rates. On the one hand, revisions in the diagnostic criteria for mild traumatic brain injury in recent years may have led to changes in case reporting. On the other hand, population aging and the increasing prevalence of traumatic brain injuries among older adults may have influenced the differences observed in study findings. Therefore, further investigations are needed to gain a deeper understanding of the factors affecting PTH prevalence and its implications for different patient groups.75

Furthermore, the impact of repetitive head trauma is not limited to military populations. Studies on amateur and retired male boxers have demonstrated that repeated and chronic head trauma in boxing may be associated with pituitary dysfunction and decreased pituitary volume, suggesting endocrine system involvement as a significant consequence of repeated brain injuries.76 In another meta-analysis conducted on adult civilians, the findings indicated that the overall estimated prevalence of post-traumatic headache (PTH) was 47.1%, which is consistent with the results of the present study. Notably, this prevalence showed little variation across different time intervals (3, 6, 12, and 36 months).77

However, sensitivity analyses in our study confirmed that excluding any single study did not significantly affect the overall prevalence, indicating stability and robustness of our findings. However, some cross-sectional studies have reported varying prevalence rates, from lower23,30,33,38 to higher,18,20,29,32 which may reflect differences in study design, population characteristics, and diagnostic criteria. Furthermore, sensitivity analyses confirmed that no single study had a disproportionate effect on the overall prevalence estimate, reinforcing the robustness and reliability of our meta-analytic results.78 One of the key reasons for the significance of these findings is the potential impact of post-traumatic headache (PTH) on patients’ neurological and psychological outcomes. Studies have shown that PTH can be associated with symptoms such as chronic fatigue, sleep disturbances, anxiety, and depression, all of which may reduce patients’ quality of life and limit their ability to return to daily activities.79

Similarly, a study on soldiers with traumatic brain injury (TBI) identified a wide range of neuropsychiatric symptoms grouped into cognitive impairments, neurobehavioral disorders (including depression, anxiety, and PTSD), and sensory disruptions, somatic symptoms such as chronic headaches and pain, and substance dependence. These symptoms are especially prevalent in soldiers exposed to blast injuries. The study highlighted the importance of using multidimensional diagnostic approaches like the biopsychosocial model to detect and manage psychological and social dysfunction in this population effectively.78

Moreover, some research has indicated that the severity and duration of headache following TBI may be linked to the severity of the initial brain injury. Therefore, identifying risk factors and developing effective treatment strategies for managing PTH could play a crucial role in improving outcomes for patients with TBI.14,55 The findings of this study showed that the prevalence of post-traumatic headache (PTH) varies significantly depending on the assessment tools used. The highest prevalence, at 65.2%, was reported in evaluations based on clinical interviews. This variation may be attributed to several factors. In interview-based methods, evaluators can obtain more detailed information from patients, interpret their responses, and ask follow-up questions if needed for clarification. This is particularly important for patients who may struggle to accurately describe their symptoms or underestimate the severity of their headaches.

Allen (2019) states that clinical interviews allow for a thorough examination of patient symptoms and facilitate a comprehensive assessment.80 In contrast, standardized questionnaires such as the Numeric Rating Scale (NRS) reported lower prevalence rates (25.2%), possibly due to their limited capacity to capture complex headache features. Due to the inherent limitations of these questionnaires, certain aspects of headache symptoms may not be fully captured. Additionally, variations in reported prevalence may result from differences in how these tools are administered, patients’ interpretations of their symptoms, and the diagnostic accuracy of each method. These findings highlight the importance of selecting an appropriate assessment tool for evaluating PTH, suggesting that clinical interviews, due to their greater flexibility and ability to explore symptoms in depth, provide a more comprehensive picture of the disorder’s prevalence.

We also found that follow-up duration significantly influenced prevalence estimates: rates were higher beyond one year (58.3%) compared to within one year (45.4%), suggesting persistence or delayed onset of PTH in some cases. Furthermore, military populations exhibited higher prevalence (56.1%) than general patient groups (45.1%), possibly reflecting more frequent head trauma or unique risk factors in these groups. It is important to note that athletes in contact sports such as boxing are also at considerable risk for repeated head trauma, which has been associated with neuroendocrine dysfunctions, including pituitary gland abnormalities, as well as chronic neuropsychiatric conditions. These factors should be considered when interpreting headache prevalence in populations exposed to head injuries. Meta-regression indicated that variables such as publication year, sample size, and mean age did not significantly affect prevalence estimates, which supports the consistency of our results. Moreover, no publication bias was detected based on Egger’s test and funnel plot analysis. We acknowledge the considerable heterogeneity in definitions and assessment methods of PTH across studies. To address this, we clarified in the manuscript that “posttraumatic headache” includes all headaches reported after TBI, regardless of whether they meet strict clinical criteria (eg, ICHD-3). This limitation has been explicitly stated to aid interpretation.

Given the high incidence of headaches among TBI patients, special attention to this condition is essential in the care and rehabilitation process. Future studies should investigate the precise mechanisms underlying PTH, associated risk factors, and optimal treatment strategies for managing this condition. Moreover, adopting a multimodal approach—including pharmacological treatments, neurorehabilitation, and behavioral interventions—may be effective in alleviating the burden of PTH.

Limitations

This study has several limitations. First, the included studies may not fully represent the broader target population, which limits the generalizability of our findings. Future research with larger, more diverse samples is needed to improve external validity. Second, the cross-sectional nature of many included studies restricts the ability to infer causality. Longitudinal or experimental designs are needed to explore causal relationships between TBI and PTH. Third, the tools used to assess PTH varied widely, and some—such as the NRS—may underestimate prevalence due to their limited capacity to capture the complexity of symptoms. In contrast, clinical interviews appear to provide a more comprehensive assessment, as supported by our subgroup analyses. Fourth, substantial heterogeneity existed across studies in how PTH was defined and measured. Although we used an inclusive approach to improve sensitivity, this may have introduced variability that complicates interpretation. Fifth, certain high-risk subgroups, such as military personnel and athletes in contact sports, may experience distinct patterns of injury and symptoms due to repeated trauma and neuroendocrine disruptions. While these populations were included in our analysis, more focused studies are needed to understand their specific risk profiles. Finally, although meta-regression found no significant effects from variables like sample size or mean age, the presence of overall heterogeneity suggests a need for more standardized definitions and assessment methodologies in future research.

Conclusion

This study indicates that the prevalence of post-traumatic headache (PTH) is influenced by multiple factors, including assessment methods, follow-up duration, and study population. Notably, clinical interviews tend to yield higher prevalence estimates than standardized questionnaires, likely due to their greater depth and flexibility. Sensitivity analyses and meta-regression confirmed the robustness of our findings, and no publication bias was detected. However, methodological variability—particularly in diagnostic criteria and assessment tools—may have contributed to differences across studies. Therefore, reported prevalence estimates should be interpreted with caution. These findings underscore the need for careful selection of assessment tools and greater standardization in PTH research. Given the significant burden of PTH on patients with TBI, future research should focus on understanding its underlying mechanisms and developing effective, multimodal treatment strategies tailored to patient subgroups.

Acknowledgement

We acknowledge the use of the PRISMA 2020 statement and flow diagram in the preparation of this review.

Disclosure

The authors report no conflicts of interest in this work.

References

1. Dewan MC, Rattani A, Gupta S, et al. Estimating the global incidence of traumatic brain injury. J Neurosurg. 2019;1–18.

2. Siebold L, Obenaus A, Goyal R. Criteria to define mild, moderate, and severe traumatic brain injury in the mouse controlled cortical impact model. Exp Neurol. 2018;310:48–57. doi:10.1016/j.expneurol.2018.07.004

3. Shepetovsky D, Mezzini G, Magrassi L. Complications of cranioplasty in relationship to traumatic brain injury: a systematic review and meta-analysis. Neurosurg Rev. 2021;44(6):3125–3142.

4. Azouvi P, Arnould A, Dromer E, Vallat-Azouvi C. Neuropsychology of traumatic brain injury: an expert overview. Revue neurologique. 2017;173(7–8):461–472.

5. Christensen RH, Al-Khazali HM, Iljazi A, Szabo E, Ashina H. Functional magnetic resonance imaging of post-traumatic headache: a systematic review. Curr Pain Headache Rep. 2025;29(1):27. doi:10.1007/s11916-024-01351-2

6. Mavroudis I, Ciobica A, Luca AC, Balmus I-M. Post-traumatic headache: a review of prevalence, clinical features, risk factors, and treatment strategies. J Clin Med. 2023;12(13):4233. doi:10.3390/jcm12134233

7. Naugle KM, Carey C, Evans E, et al. The role of deficient pain modulatory systems in the development of persistent post-traumatic headaches following mild traumatic brain injury: an exploratory longitudinal study. J Headache Pain. 2020;21:1–12. doi:10.1186/s10194-020-01207-1

8. Ashina H, Al-Khazali HM, Iljazi A, et al. Psychiatric and cognitive comorbidities of persistent post-traumatic headache attributed to mild traumatic brain injury. J Headache Pain. 2021;22:1–10. doi:10.1186/s10194-021-01287-7

9. Argyriou AA, Mitsikostas -D-D, Mantovani E, Litsardopoulos P, Panagiotopoulos V, Tamburin S. An updated brief overview on post-traumatic headache and a systematic review of the non-pharmacological interventions for its management. Expert Rev Neurotherap. 2021;21(4):475–490. doi:10.1080/14737175.2021.1900734

10. Munn Z, Barker TH, Moola S, et al. Methodological quality of case series studies: an introduction to the JBI critical appraisal tool. JBI Evidence Synth. 2020;18(10):2127–2133. doi:10.11124/JBISRIR-D-19-00099

11. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021:372:n71. doi:10.1136/bmj.n71

12. Faux S, Sheedy J. A prospective controlled study in the prevalence of posttraumatic headache following mild traumatic brain injury. Pain Med. 2008;9(8):1001–1011. doi:10.1111/j.1526-4637.2007.00404.x

13. Lieba-Samal D, Platzer P, Seidel S, Klaschterka P, Knopf A, Wöber C. Characteristics of acute posttraumatic headache following mild head injury. Cephalalgia. 2011;31(16):1618–1626. doi:10.1177/0333102411428954

14. Beswick-Escanlar VP, Lee T, Hu Z, Clark LL. Increasing severity of traumatic brain injury is associated with an increased risk of subsequent headache or migraine: a retrospective cohort study of U.S. active duty service members, 2006–2015. Msmr. 2016;23(7):2–8.

15. Hoffman JM, Ketchum JM, Agtarap S, et al. Characterizing extreme phenotypes for pain interference in persons with chronic pain following traumatic brain injury: a NIDILRR and VA TBI Model Systems Collaborative Project. J Head Trauma Rehabil. 2024;39(1):31–42. doi:10.1097/HTR.0000000000000909

16. Harrison-Felix C, Sevigny M, Beaulieu CL, et al. Characterization and treatment of chronic pain after traumatic brain injury—comparison of characteristics between individuals with current pain, past pain, and no pain: a NIDILRR and VA TBI Model Systems Collaborative Project. J Head Trauma Rehabil. 2024;39(1):5–17. doi:10.1097/HTR.0000000000000910

17. Chong CD, Nikolova S, Dumkrieger G, et al. Thalamic subfield iron accumulation after acute mild traumatic brain injury as a marker of future post-traumatic headache intensity. Headache. 2023;63(1):156–164. doi:10.1111/head.14446

18. Ashina H, Dodick DW, Barber J, et al. Prevalence of and risk factors for post-traumatic headache in civilian patients after mild traumatic brain injury: a TRACK-TBI Study. Mayo Clin Proc. 2023;98(10):1515–1526. doi:10.1016/j.mayocp.2023.02.026

19. Flynn S, Moore B, van der Merwe AJ, et al. Headaches in traumatic brain injury: improvement over time, associations with quality of life, and impact of migraine-type headaches. J Head Trauma Rehabil. 2023;38(2):E109–e17. doi:10.1097/HTR.0000000000000790

20. Coffman C, Reyes D, Hess MC, et al. Relationship between headache characteristics and a remote history of TBI in veterans. Neurology. 2022;99(2):e187–e98. doi:10.1212/WNL.0000000000200518

21. Licona N, Chung J, Madrigal E, Harris O. Post-traumatic headaches after traumatic brain injury in a military and veteran cohort. Arch Phys Med Rehabil. 2022;103(12):e155. doi:10.1016/j.apmr.2022.08.849

22. Couch JR, Stewart KE. Persistence of headache and its relation to other major sequelae following traumatic brain injury at 2–8 years after deployment-related traumatic brain injury in veterans of Afghanistan and Iraq wars. Headache. 2022;62(6):700–717. doi:10.1111/head.14303

23. Leibovit-Reiben Z, Ishii R, Dodick DW, et al. The impact of pre-morbid headaches on headache features and long-term health outcomes following traumatic brain injury: insights from the American Registry for Migraine Research. Headache. 2022;62(5):566–576. doi:10.1111/head.14311

24. Karr JE, Williams MW, Iverson GL, Huang SJ, Yang CC. Pre-Injury headache and post-traumatic headache in patients with mild traumatic brain injury: neuropsychological, psychiatric, and post-concussion symptom outcomes. Brain Injury. 2022;36(2):175–182. doi:10.1080/02699052.2022.2043440

25. Kraemer Y, Mäki K, Marinkovic I, et al. Post-traumatic headache after mild traumatic brain injury in a one-year follow up study - risk factors and return to work. J Headache Pain. 2022;23(1):27. doi:10.1186/s10194-022-01398-9

26. Kothari SF, Eggertsen PP, Frederiksen OV, et al. Characterization of persistent post-traumatic headache and management strategies in adolescents and young adults following mild traumatic brain injury. Sci Rep. 2022;12(1):2209. doi:10.1038/s41598-022-05187-x

27. Bosak N, Branco P, Kuperman P, et al. Brain connectivity predicts chronic pain in acute mild traumatic brain injury. Ann Neurol. 2022;92(5):819–833. doi:10.1002/ana.26463

28. Meltzer KJ, Juengst SB. Associations between frequent pain or headaches and neurobehavioral symptoms by gender and TBI severity. Brain Injury. 2021;35(1):41–47. doi:10.1080/02699052.2020.1857438

29. Portanova J, Buchanan D, Moore M, Thompson H. Factors associated with the development of persistent pain after mTBI. Pain Manage Nurs. 2021;22(5):592–598. doi:10.1016/j.pmn.2021.04.001

30. Hoffman JM, Lucas S, Dikmen S, Temkin N. Clinical perspectives on headache after traumatic brain injury. PM & R J Inj Funct Rehabil. 2020;12(10):967–974. doi:10.1002/pmrj.12338

31. Nordhaug LH, Linde M, Follestad T, et al. Change in headache suffering and predictors of headache after mild traumatic brain injury: a population-based, controlled, longitudinal study with twelve-month follow-up. J Neurotrauma. 2019;36(23):3244–3252. doi:10.1089/neu.2018.6328

32. Suri P, Stolzmann K, Williams R, Pogoda TKJTJo P. Deployment-related traumatic brain injury and risk of new episodes of care for back pain in veterans. J Pain. 2019;20(1):97–107. doi:10.1016/j.jpain.2018.08.002

33. Pugh MJ, Swan AA, Amuan ME, et al. Deployment, suicide, and overdose among comorbidity phenotypes following mild traumatic brain injury: a retrospective cohort study from the Chronic Effects of Neurotrauma Consortium. PLoS One. 2019;14(9):e0222674. doi:10.1371/journal.pone.0222674

34. Howard L, Dumkrieger G, Chong CD, Ross K, Berisha V, Schwedt TJ. Symptoms of autonomic dysfunction among those with persistent posttraumatic headache attributed to mild traumatic brain injury: a comparison to migraine and healthy controls. Headache. 2018;58(9):1397–1407. doi:10.1111/head.13396

35. Nordhaug LH, Hagen K, Vik A, et al. Headache following head injury: a population-based longitudinal cohort study (HUNT). J Headache Pain. 2018;19(1):8.

36. Kulas JF, Rosenheck RA. A comparison of veterans with post-traumatic stress disorder, with mild traumatic brain injury and with both disorders: understanding multimorbidity. Mil Med. 2018;183(3–4):e114–e22. doi:10.1093/milmed/usx050

37. Walker WC, Hirsch S, Carne W, et al. Chronic Effects of Neurotrauma Consortium (CENC) multicentre study interim analysis: differences between participants with positive versus negative mild TBI histories. Brain Injury. 2018;32(9):1079–1089. doi:10.1080/02699052.2018.1479041

38. Hong CK, Joo JY, Shim YS, et al. The course of headache in patients with moderate-to-severe headache due to mild traumatic brain injury: a retrospective cross-sectional study. J Headache Pain. 2017;18(1):48. doi:10.1186/s10194-017-0755-9

39. Yilmaz T, Roks G, de Koning M, et al. Risk factors and outcomes associated with post-traumatic headache after mild traumatic brain injury. Emer Med J. 2017;34(12):800–805. doi:10.1136/emermed-2015-205429

40. Stacey A, Lucas S, Dikmen S, et al. Natural history of headache five years after traumatic brain injury. J Neurotrauma. 2017;34(8):1558–1564.

41. Suri P, Stolzmann K, Iverson KM, et al. Associations between traumatic brain injury history and future headache severity in veterans: a longitudinal study. Arch Phys Med Rehabil. 2017;98(11):2118–25.e1. doi:10.1016/j.apmr.2017.04.008

42. Schwab K, Terrio HP, Brenner LA, et al. Epidemiology and prognosis of mild traumatic brain injury in returning soldiers: a cohort study. Neurology. 2017;88(16):1571–1579. doi:10.1212/WNL.0000000000003839

43. Lucas S, Smith BM, Temkin N, Bell KR, Dikmen S, Hoffman JM. Comorbidity of headache and depression after mild traumatic brain injury. Headache. 2016;56(2):323–330. doi:10.1111/head.12762

44. Xu H, Pi H, Ma L, Su X, Wang J. Incidence of headache after traumatic brain injury in China: a large prospective study. World Neurosurg. 2016;88:289–296. doi:10.1016/j.wneu.2015.12.028

45. Nordhaug LH, Vik A, Hagen K, et al. Headaches in patients with previous head injuries: a population-based historical cohort study (HUNT). Cephalalgia. 2016;36(11):1009–1019. doi:10.1177/0333102415618948

46. Jackson CE, Green JD, Bovin MJ, et al. Mild traumatic brain injury, PTSD, and psychosocial functioning among male and female US OEF/OIF veterans. J Traumatic Stress. 2016;29(4):309–316. doi:10.1002/jts.22110

47. Sawyer K, Bell KR, Ehde DM, et al. Longitudinal study of headache trajectories in the year after mild traumatic brain injury: relation to posttraumatic stress disorder symptoms. Arch Phys Med Rehabil. 2015;96(11):2000–2006. doi:10.1016/j.apmr.2015.07.006

48. Webb TS, Whitehead CR, Wells TS, Gore RK, Otte CN. Neurologically-related sequelae associated with mild traumatic brain injury. Brain Injury. 2015;29(4):430–437.

49. DiTommaso C, Hoffman JM, Lucas S, Dikmen S, Temkin N, Bell KR. Medication usage patterns for headache treatment after mild traumatic brain injury. Headache. 2014;54(3):511–519. doi:10.1111/head.12254

50. Kjeldgaard D, Forchhammer H, Teasdale T, Jensen RH. Chronic post-traumatic headache after mild head injury: a descriptive study. Cephalalgia. 2014;34(3):191–200. doi:10.1177/0333102413505236

51. Laborey M, Masson F, Ribéreau-Gayon R, Zongo D, Salmi LR, Lagarde E. Specificity of postconcussion symptoms at 3 months after mild traumatic brain injury: results from a comparative cohort study. J Head Trauma Rehabil. 2014;29(1):E28–E36.

52. Lucas S, Hoffman JM, Bell KR, Dikmen S. A prospective study of prevalence and characterization of headache following mild traumatic brain injury. Cephalalgia. 2014;34(2):93–102. doi:10.1177/0333102413499645

53. King PR, Wade MJ, Beehler GP. Health service and medication use among veterans with persistent postconcussive symptoms. J Nerv Ment Dis. 2014;202(3):231–238. doi:10.1097/NMD.0000000000000103

54. Brickell TA, Lange RT, French LM. Health-related quality of life within the first 5 years following military-related concurrent mild traumatic brain injury and polytrauma. Mil Med. 2014;179(8):827–838. doi:10.7205/MILMED-D-13-00506

55. Walker WC, Marwitz JH, Wilk AR, et al. Prediction of headache severity (density and functional impact) after traumatic brain injury: a longitudinal multicenter study. Cephalalgia. 2013;33(12):998–1008. doi:10.1177/0333102413482197

56. Åhman S, Saveman B-I, Styrke J, Björnstig U, Stålnacke B-M. Long-term follow-up of patients with mild traumatic brain injury: a mixed-methods study. J Rehabil med. 2013;45(8):758–764. doi:10.2340/16501977-1182

57. MacGregor AJ, Dougherty AL, Tang JJ, Galarneau MR. Postconcussive symptom reporting among US combat veterans with mild traumatic brain injury from Operation Iraqi Freedom. J Head Trauma Rehabil. 2013;28(1):59–67.

58. Lucas S, Hoffman JM, Bell KR, Walker W, Dikmen S. Characterization of headache after traumatic brain injury. Cephalalgia. 2012;32(8):600–606. doi:10.1177/0333102412445224

59. Tham S, Palermo T, Jimenez N, Wang J, Vavilala M, Rivara F. Persistent pain following traumatic brain injury in a pediatric population. J Pain. 2012;13(4):S22. doi:10.1016/j.jpain.2012.01.097

60. Theeler BJ, Flynn FG, Erickson JC. Chronic Daily Headache in US Soldiers After Concussionhead_2112. 2012.

61. Romesser J, Booth J, Benge J, Pastorek N, Helmer D. Mild traumatic brain injury and pain in Operation Iraqi Freedom/Operation Enduring Freedom veterans. J Rehabil Res Dev. 2012;49(7):1127–1138. doi:10.1682/JRRD.2010.12.0238

62. Wilk JE, Herrell RK, Wynn GH, Riviere LA, Hoge CW. Mild traumatic brain injury (concussion), posttraumatic stress disorder, and depression in US soldiers involved in combat deployments: association with postdeployment symptoms. Psychosomatic Med. 2012;74(3):249–257. doi:10.1097/PSY.0b013e318244c604

63. Colantonio A, Comper PJ. Post-injury symptoms after work related traumatic brain injury in Canadian population. Work. 2012;43(2):195–201. doi:10.3233/WOR-2012-1377

64. Hoffman JM, Lucas S, Dikmen S, et al. Natural history of headache after traumatic brain injury. J Neurotrauma. 2011;28(9):1719–1725. doi:10.1089/neu.2011.1914

65. Patil VK, St. Andre JR, Crisan E, et al. Prevalence and treatment of headaches in veterans with mild traumatic brain injury. Headache. 2011;51(7):1112–1121. doi:10.1111/j.1526-4610.2011.01946.x

66. Wilk JE, Thomas JL, McGurk DM, Riviere LA, Castro CA, Hoge CW. Mild traumatic brain injury (concussion) during combat: lack of association of blast mechanism with persistent postconcussive symptoms. J Head Trauma Rehabil. 2010;25(1):9–14. doi:10.1097/HTR.0b013e3181bd090f

67. Chaput G, Giguère JF, Chauny JM, Denis R, Lavigne G. Relationship among subjective sleep complaints, headaches, and mood alterations following a mild traumatic brain injury. Sleep Med. 2009;10(7):713–716. doi:10.1016/j.sleep.2008.07.015

68. Vanderploeg RD, Belanger HG, Curtiss GJ. Mild traumatic brain injury and posttraumatic stress disorder and their associations with health symptoms. Arch Phys Med Rehabil. 2009;90(7):1084–1093. doi:10.1016/j.apmr.2009.01.023

69. McCartan D, Fleming F, Motherway C, Grace P. Management and outcome in patients following head injury admitted to an Irish Regional Hospital. Brain Injury. 2008;22(4):305–312. doi:10.1080/02699050801995124

70. Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in US soldiers returning from Iraq. N Engl J Med. 2008;358(5):453–463. doi:10.1056/NEJMoa072972

71. Ruff RL, Wang X. Headaches among Operation Iraqi Freedom/Operation Enduring Freedom veterans with mild traumatic brain injury associated with exposures to explosions. J Rehabil Res Dev. 2008;45(7):941–952. doi:10.1682/JRRD.2008.02.0028

72. Nestvold K, Lundar T, Mowinckel P, Stavem K. Predictors of headache 22 years after hospitalization for head injury. Acta Neurol Scand. 2005;112(1):13–18. doi:10.1111/j.1600-0404.2005.00344.x

73. Warden DL, Ryan L, Helmick KM, et al. War Neurotrauma: The Defense and Veterans Brain Injury Center (DVBIC) Experience at. Walter Reed Army Medical Center (WRAMC); 2005:1178.

74. Walker WC, Seel RT, Curtiss G, Warden DL. Headache after moderate and severe traumatic brain injury: a longitudinal analysis. Arch Phys Med Rehabil. 2005;86(9):1793–1800. doi:10.1016/j.apmr.2004.12.042

75. Nampiaparampil DE. Prevalence of chronic pain after traumatic brain injury: a systematic review. JAMA. 2008;300(6):711–719. doi:10.1001/jama.300.6.711

76. Tanriverdi F, Unluhizarci K, Kocyigit I, et al. Brief communication: pituitary volume and function in competing and retired male boxers. Ann Internal Med. 2008;148(11):827–831. doi:10.7326/0003-4819-148-11-200806030-00005

77. Babiloni AH, Bouferguene Y, Exposto FG, et al. The prevalence of persistent post-traumatic headache in adult civilian traumatic brain injury: a systematic review and meta-analysis on the past 14 years. Pain. 2022.

78. Halbauer JD, Ashford JW, Zeitzer JM, Adamson MM, Lew HL, Yesavage JA. Neuropsychiatric diagnosis and management of chronic sequelae of war-related mild to moderate traumatic brain injury. J Rehabil Res Dev. 2009;46(6):757–796. doi:10.1682/JRRD.2008.08.0119

79. Schiehser DM, Twamley EW, Liu L, et al. The relationship between postconcussive symptoms and quality of life in veterans with mild to moderate traumatic brain injury. J Head Trauma Rehabil. 2015;30(4):E21–E8. doi:10.1097/HTR.0000000000000065

80. Allen DN, Becker ML. Clinical interviewing. In: Handbook of Psychological Assessment. 2019:307–336.