Accession Number:

ADA552102

Title:

Headaches During War: Analysis of Presentation, Treatment, and Factors Associated with Outcome

Descriptive Note:

Journal article

Corporate Author:

WALTER REED ARMY MEDICAL CENTER WASHINGTON DC

Report Date:

2011-01-01

Pagination or Media Count:

18.0

Abstract:

Background Headache is often associated with physical trauma and psychological stress. The aim of this study is to evaluate the impact of headache on personnel deployed in war zones and to identify factors associated with return to duty RTD. Methods Outcome data were prospectively collected on 985 personnel medically evacuated out of Operations Iraqi and Enduring Freedom for a primary diagnosis of headache between 2004 and 2009. Electronic medical records were reviewed to examine clinical and treatment patterns and the effect that myriad factors had on RTD. Results 33.6 of evacuees returned to duty. The most common headaches were post-concussion 34.1 and migraine 30.0. Headaches typically associated with trauma such as post-concussion 18.7, occipital neuralgia 23.1, and cervicogenic headache 29.7 had the lowest RTD rates, whereas tension headache 49.6 was associated with the best outcome. Other variables associated with negative outcome included presence of aura OR 0.51, 95 CI 0.30 0.88 p0.02, traumatic brain injury OR 0.50, 95 CI 0.29 0.87 p0.01, opioid OR 0.41, 95 CI 0.26 0.63 p0.001, and beta-blocker OR 0.26, 95 CI 0.12 0.61 p0.002 use, and co-existing psychopathology p0.001 in univariable analysis. Conclusion Headaches represent a significant cause of unit attrition in personnel deployed in military operations, with physical trauma and co-existing psychopathology associated with poorer outcomes.

Subject Categories:

  • Medicine and Medical Research

Distribution Statement:

APPROVED FOR PUBLIC RELEASE