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Table 1 Comparison of the characteristics between persistent PTH and primary headaches

From: Persistent post-traumatic headache: a migrainous loop or not? The clinical evidence

  Persistent PTH Migraine Tension-type headache Cluster headache
Prevalence 18–58% after TBI 6–33% 62% 0.1%
Risk factors -Prior history of headache
-Female gender
- Older age
- Family history of headache
-Young age
-Female gender
-Anxiety
-Depression
-Young age
-Male gender
Duration of episodes Variable 180 min-3 days 30 min-7 days 15–180 min
Headache symptoms -Migraine-like
-Tension-type headache like
-Cluster like
-Severe intensity
-Unilateral location
-Pulsatile quality
-Aggravated by activity
-Mild/moderate intensity
-Bilateral location
-Pressing quality
-Not aggravated by activity
-Severe intensity
-Unilateral, orbital or periorbital
Associated symptoms -Sleep disorders
-Affective and behavioral disorders
-Cognitive deficits
-Nausea or vomiting
-Photophobia and phonophobia
-Photophobia, phonophobia or nausea -Conjunctival injection, nasal congestion, eyelid edema, miosis, ptosis.
-Sense of restlessness or agitation
Imaging (MRI) -Less cortical thickness in bilateral frontal regions and right hemisphere parietal regions of the brain
-Gray matter changes in the prefrontal cortex.
-White matter hyperintensities -Normal -Normal
Neurophysiological studies (EEG) Early abnormalities (focal slowing, absence of activity, amplitude asymmetries) -H response to flicker stimulation
-Abnormal resting-state EEG rhythmic activity
Normal Normal
Treatment -Behavioral
-Drugs depending on phenotype
-Acute: NAIDs / triptans
-Preventive: β-blockers, antiepileptics, antihypertensive, CGRP Abs
-Acute: NAIDs
-Preventive: antidepressants
-Acute: triptans/O2
-Preventive: corticosteroids, verapamil
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