Back to Top Skip to main content Skip to sub-navigation

DVBIC study focuses on concussion-related headaches

Image of Soldier (center) standing at attention receives an award pinned to their uniform, from a soldier standing directly before her, with a soldier standing at attention to one side. A long building is seen in the background with two flagpoles, one flying the US flag. Stephanie Ehlers is awarded a Purple Heart on April 8, 2007 for injuries sustained in Iraq. She had bilateral perforations of the eardrums and a TBI. (Photo Courtesy of Stephanie Ehlers)

Recommended Content:

Traumatic Brain Injury

Headaches are the most common form of pain, according to the National Institutes of Health’s National Library of Medicine. 

Service members with concussion-related headaches often experience more frequent and severe pain compared to those with headaches unrelated to this condition, according to recently published data from the Warrior Strong Study. This multi-year research project was conducted by the Defense and Veterans Brain Injury Center, a division of the Defense Health Agency Research and Development Directorate.

Headaches remain the most frequently reported symptom among service members who have sustained concussions, also known as mild traumatic brain injuries. Seventy-four percent of participants in Operation Enduring Freedom and Operation Iraqi Freedom had post-traumatic headaches within 30 days of sustaining a concussion, as reported by DVBIC.

Between 2009 and 2015, DVBIC researchers surveyed more than 1,500 soldiers, and then followed up with them after three months, then again after six months, and finally, a year later.

“We wanted to find out how active-duty soldiers were doing after coming back from the war zone with concussion,” said Karen Schwab, DVBIC researcher and the study’s principal investigator. Ultimately, the findings may inform DVBIC’s future clinical recommendations and guidelines in the prevention, diagnosis, and treatment of concussions in the U.S. armed forces.

In total, researchers interviewed 1,567 soldiers from combat operations in Afghanistan and Iraq during post deployment health assessments at Fort Carson, Colorado and Fort Bragg, North Carolina. Participants answered 31 headache-related questions to help researchers identify post-traumatic headaches. The soldiers were asked about how frequent and how painful their headaches were, compared to before they deployed, and if their headaches changed after an injury, illness, or some other event during deployment.

Of the 1,094 soldiers who reported headaches, 557 had also experienced concussions. For soldiers whose headaches were related to their concussion, symptoms were more severe and more often led to medical consultation, compared to the group whose headaches were unrelated to TBI.

Post-traumatic headaches often resemble migraines, a painful sensation in the head often associated with nausea and sensitivity to light, among other symptoms.

Notably, the gender composition of the Warrior Strong study differed markedly from studies of migraine headaches in civilian populations. Overall, 91% of the Warrior Strong participants and 94% of those with concussions were male. By contrast, civilian clinical studies on migraines are performed on groups that are around 80% women, a reflection of the demographic fact that adult women are two-to-three times more likely to suffer from migraines than men.

“The evidence base for treating headaches is not specific to post-traumatic headaches. And it may or may not be relevant for treating them. We really don’t know,” said Ann Scher, a professor of epidemiology at Uniformed Services University and the study’s corresponding author.

While there are no specific drug therapies for post-traumatic headaches approved by the Food and Drug Administration, the study results could lead to the design of clinical trials and the development of targeted pharmaceutical remedies, Scher said.

Fortunately, there are multiple behavior changes and medical modalities to treat and reduce the severity of post-traumatic headaches; these include improving sleep patterns, muscle relaxation, anxiety reducing techniques, physical therapy, cognitive behavior therapy, and acupuncture.

To help patients in their care, DVBIC developed the Headache Virtual Suite to offer health care providers a step-by-step process to determine the type of post-traumatic headaches and guidance on its evaluation and treatment.

After her second TBI, former soldier Stephanie Ehlers was told by her medical provider to rest for 24 hours without providing additional therapeutic guidance. When her TBI was more accurately diagnosed a few years later, the former Army Medical Service Corps officer learned various coping methods that set her on the road to recovery.

Ehlers, who also described her experiences as part of DVBIC’s educational campaign called ‘A Head for the Future’, concluded by stating, “Early identification and early treatment of TBI is so important.”

You also may be interested in...

PRA Training Video 1: PRA Overview

Video
7/22/2021
PRA Training Video 1: PRA Overview

In the first of TBICoE's Progressive Return to Activity (PRA) video training series, you will learn about the reasons for using a progressive return to activity process and receive an overview of the 2021 PRA algorithm and its associated tools. By the end of lesson one, providers will better understand the PRA process, and explain that process to service members diagnosed with concussion. Each video in the PRA training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 5: The Six Stages of the PRA

Video
7/22/2021
PRA Training Video 5: The Six Stages of the PRA

In this lesson, we cover the key activity objectives for each of the six stages of the Progressive Return to Activity (PRA) Clinical Recommendation and provide activity examples for each stage. Each stage is designed to gradually increase the intensity and duration of a service member's physical and cognitive activity as they advance in the PRA process. Each video in the PRA training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 4: PRA Progression Criteria

Video
7/22/2021
PRA Training Video 4: PRA Progression Criteria

In this lesson, we review the criteria for advancing through the stages of the Progressive Return to Activity (PRA) Clinical Recommendation. Each video in the PRA training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Provider Resources | Provider Education | Traumatic Brain Injury

Caregiver Guide supports service members and veterans with TBI

Article
7/22/2021
Military family posing for a picture

Traumatic Brain Injury Center of Excellence’s 2021 Caregiver Guide provides specific tools to help caregivers manage TBI patient recovery.

Recommended Content:

Centers of Excellence | Traumatic Brain Injury | Education & Training Events

2020 TBICoE Annual Report

Publication
7/9/2021

2020 Traumatic Brian Injury Center of Excellence (TBICoE) Annual Report.

Recommended Content:

Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury

Traumatic Brain Injury: A Guide for Caregivers of Service Members and Veterans

Publication
7/7/2021

The 2021 "Traumatic Brain Injury: A Guide for Caregivers of Service Members and Veterans" is a recovery support tool to assist caregivers of service members and veterans who have sustained a traumatic brain injury at any severity level.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Educators | Traumatic Brain Injury | Psychological Health Center of Excellence

TBI Caregiver Support Forms

Form/Template
6/29/2021

This is a fillable and printer-friendly version of the forms available in the "Traumatic Brain Injury: A Guide for Caregivers of Service Members and Veterans."

Recommended Content:

Traumatic Brain Injury | Traumatic Brain Injury Center of Excellence | Patient and Family Resources

Aphasia, Caused by Stroke or TBI, is Frustrating and Little Known

Article
6/29/2021
A doctor looking at brain scans

Aphasia is an incurable disease usually caused by stroke that affects all forms of communication.

Recommended Content:

Total Force Fitness | Heart Health | Centers of Excellence | Traumatic Brain Injury

NICoE Education Webinar Series: July Poster

Publication
6/25/2021

Service Members and TBI: The Not So Invisible Wound

Recommended Content:

Traumatic Brain Injury | Education & Training Events | Centers of Excellence

NICoE Education Webinar Series: June Poster

Publication
6/23/2021

Combat-related Concussion: Understanding Trajectories of Long-term Clinical and Imaging Outcomes

Recommended Content:

Traumatic Brain Injury | Education & Training Events

TBICoE Virtual Quarterly Education Series: July 2021

Publication
6/22/2021

The Traumatic Brain Injury Center of Excellence is hosting a caregiver education series to learn about TBI caregiver resources, mind-body wellness exercises, and current research in the field.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Educators | Traumatic Brain Injury | Education & Training Events

Progressive Return to Activity Following Concussion/mTBI Patient and Leadership Guide

Publication
6/22/2021

The Progressive Return to Activity Following Concussion/mTBI Patient and Leadership Guide alerts command and line leaders about the PRA process and provides service members with appropriate activities for each stage of their recovery.

Recommended Content:

Traumatic Brain Injury Center of Excellence | Patient and Family Resources | Traumatic Brain Injury | TBI Resources

TBI Topic Page Review Form

Publication
5/21/2021

The Traumatic Brain Injury Center of Excellence (TBICoE) manages the content on the Health.mil Traumatic Brain Injury Topic Page for the Defense Health Agency (DHA). To submit content for review and approval to this page, Military Health System agencies and other government partners can email this form, along with attached content in a Word document, to the TBICoE website manager at dha.TBICoEinfo@mail.mil.

Recommended Content:

Traumatic Brain Injury

Signs and symptoms of a stroke, and what to do about them

Article
5/18/2021
Infographic about the sign of a stroke

For Stroke Awareness Month, we highlight some of the most important facts about strokes in men and women.

Recommended Content:

Health Readiness & Combat Support | Traumatic Brain Injury

TRIP initiative bridges the gap between TBI research, clinical care

Article
5/13/2021
a statue of a broken circle

The Defense Intrepid Network launches the TRIP initiative to translate research findings into clinical practice.

Recommended Content:

Traumatic Brain Injury | Centers of Excellence | The National Intrepid Center of Excellence
<< < 1 2 3 4 5  ... > >> 
Showing results 46 - 60 Page 4 of 15
Refine your search
Last Updated: July 09, 2021

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.