Veterans who were deployed to combat zones in the Iraq and Afghanistan wars and experienced traumatic brain injury (TBI) have a strong and highly significant increase in the frequency and intensity of headaches, the majority of which are migraines, according to researchers.
The incidence of chronic daily headache (ie, 15 or more headache days per month) was three times greater, compared with controls, and the incidence of frequent headache (ie, 10 to 14 headache days per month) was 4.5 times greater in these soldiers than in control groups, reported lead author James R. Couch, MD, of the University of Oklahoma School of Medicine in Oklahoma City, and colleagues. “Combat zone deployment by itself is stressful. Since TBI is the signature injury of these wars and occurs in 15% to 20% of deployed soldiers, and both TBI and stress are known to be associated with headache, we sought to evaluate the differences in headache occurrence and severity between those who were deployed and those who were deployed and also experienced a TBI,” Dr. Couch said.
Dr. Couch and his team evaluated 53 pairs of deployed veterans with TBI and a matched group of veterans who were deployed but did not sustain a TBI (controls). All subjects with deployment-related TBI had headache, while 11 (23.9%) controls had no headache. In addition, 89% of headaches in the deployed veterans with TBI were migraine, compared with 40% in the control group. All subjects with deployment-related TBI reported significantly greater frequency and intensity of headache than the control group did.