Prevalence of head trauma in patients with difficult headache: the North Norway Headache Study

OBJECTIVE: To test whether chronic headache (>3 days/week) is more prevalent than episodic headache (<3 days/week) in patients with a previous history of significant head trauma. METHOD: We included 903 consecutive patients referred to a specialist center for headache during a period of 2 years. As the main parameter, we selected self-reported history of previous significant head trauma defined as loss of consciousness or hospitalization due to head trauma. RESULTS: One hundred eighty-nine out of 903 patients with difficult headache referred to a neurologist had a previous history of head trauma (21%). We identified 297 patients with headache 3 days or more per week (33%). Of these patients with chronic headache, 68 (23%) reported previous significant head trauma compared with 121/714 (17%) in other patients with headache (P =.18). Shorter length of education was associated with chronic headache; however, age, sex, or specific headache syndromes such as migraine or tension headache were not related to chronicity. CONCLUSION: Although the incidence of previous head trauma was prevalent in this highly selected group of patients with headache, such a history was not a predictor of chronicity.