Kafa Travmasına Bağlı Baş Ağrısının Tedavisi
Özet
Posttravmatik baş ağrısı (PTBA), özellikle hafif travmatik beyin hasarı sonrası sık görülen ve yaşam kalitesini belirgin şekilde düşüren sekonder bir baş ağrısıdır. Uluslararası sınıflamaya göre travmadan sonraki ilk 7 gün içinde başlayan baş ağrıları PTBA olarak tanımlanır; 3 aydan kısa sürenler akut, daha uzun sürenler kronik PTBA kabul edilir. Epidemiyolojik veriler, PTBA’nın en sık hafif TBH sonrası ortaya çıktığını ve olguların önemli bir kısmında baş ağrısının kronikleşebildiğini göstermektedir. Patofizyolojide bozulmuş ağrı modülasyonu, nöroenflamasyon, kortikal yayılan depresyon ve CGRP aracılı mekanizmalar rol oynar. Klinik olarak PTBA; gerilim tipi, migrenöz veya servikojenik baş ağrısı özellikleri gösterebilir ve sıklıkla karışık paternler izlenir. Tanı esas olarak ayrıntılı klinik değerlendirme ve baş ağrısı günlüğüne dayanır; nörogörüntüleme seçilmiş olgularda gereklidir. Tedavide temel ilke, altta yatan baş ağrısı tipinin doğru belirlenmesi ve bireyselleştirilmiş yaklaşımdır. Abortif ve profilaktik farmakolojik tedaviler, fizik tedavi, bilişsel-davranışçı yöntemler ve yaşam tarzı düzenlemeleri birlikte kullanılmalıdır. İlaç aşırı kullanımına bağlı baş ağrısı riskine özellikle dikkat edilmelidir.
Referanslar
Lucas, S. and H.K. Blume, Sport-related headache. Neurologic Clinics, 2017. 35(3): p. 501-521.
Olesen, J., The international classification of headache disorders: history and future perspectives. Cephalalgia, 2024. 44(1): p. 03331024231214731.
Parisi, P., et al., “Ictal epileptic headache” and the revised International Headache Classification (ICHD-3) published in Cephalalgia 2018, vol. 38 (1) 1–211: Not just a matter of definition! Epilepsy & Behavior, 2018. 87: p. 243-245.
Nampiaparampil, D.E., Prevalence of chronic pain after traumatic brain injury: a systematic review. Jama, 2008. 300(6): p. 711-719.
Society, H.C.C.o.t.I.H., Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia, 1988. 8(7): p. 1-96.
Maas, A.I., et al., Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. The Lancet Neurology, 2017. 16(12): p. 987-1048.
Feigin, V.L., et al., Incidence of traumatic brain injury in New Zealand: a population-based study. The Lancet Neurology, 2013. 12(1): p. 53-64.
Lucas, S., et al., A prospective study of prevalence and characterization of headache following mild traumatic brain injury. Cephalalgia, 2014. 34(2): p. 93-102.
Yilmaz, T., et al., Risk factors and outcomes associated with post-traumatic headache after mild traumatic brain injury. Emergency medicine journal, 2017. 34(12): p. 800-805.
Cnossen, M.C., et al., Prediction of persistent post-concussion symptoms after mild traumatic brain injury. Journal of neurotrauma, 2018. 35(22): p. 2691-2698.
Theeler, B.J., F.G. Flynn, and J.C. Erickson, Headaches after concussion in US soldiers returning from Iraq or Afghanistan. Headache: The Journal of Head and Face Pain, 2010. 50(8): p. 1262-1272.
Baandrup, L. and R. Jensen, Chronic post-traumatic headache–a clinical analysis in relation to the international headache classification 2nd edition. Cephalalgia, 2005. 25(2): p. 132-138.
Kjeldgaard, D., et al., Chronic post-traumatic headache after mild head injury: a descriptive study. Cephalalgia, 2014. 34(3): p. 191-200.
Ashina, H., et al., Post-traumatic headache: epidemiology and pathophysiological insights. Nature Reviews Neurology, 2019. 15(10): p. 607-617.
Ladak, A.A., S.A. Enam, and M.T. Ibrahim, A review of the molecular mechanisms of traumatic brain injury. World neurosurgery, 2019. 131: p. 126-132.
Charles, A. and P. Pozo-Rosich, Targeting calcitonin gene-related peptide: a new era in migraine therapy. The Lancet, 2019. 394(10210): p. 1765-1774.
Ashina, H., et al., Efficacy, tolerability, and safety of erenumab for the preventive treatment of persistent post-traumatic headache attributed to mild traumatic brain injury: an open-label study. The Journal of Headache and Pain, 2020. 21: p. 1-9.
Andersen, A.M., et al., Risk factors for the development of post‐traumatic headache attributed to traumatic brain injury: a systematic review. Headache: The Journal of Head and Face Pain, 2020. 60(6): p. 1066-1075.
Hoffman, J.M., et al., Natural history of headache after traumatic brain injury. Journal of neurotrauma, 2011. 28(9): p. 1719-1725.
Stacey, A., et al., Natural history of headache five years after traumatic brain injury. Journal of neurotrauma, 2017. 34(8): p. 1558-1564.
Sawyer, K., et al., Longitudinal study of headache trajectories in the year after mild traumatic brain injury: relation to posttraumatic stress disorder symptoms. Archives of physical medicine and rehabilitation, 2015. 96(11): p. 2000-2006.
Babcock, L., et al., Predicting postconcussion syndrome after mild traumatic brain injury in children and adolescents who present to the emergency department. JAMA pediatrics, 2013. 167(2): p. 156-161.
Ruff, R., S. Ruff, and X. Wang, Headaches among veterans of Operations Iraqi Freedom and Enduring Freedom with mild traumatic brain injury associated with exposures to explosions. J Rehabil Res Dev, 2008. 45: p. 941-53.
Ruff, R.L., R.G. Riechers, and S.S. Ruff, Relationships between mild traumatic brain injury sustained in combat and post-traumatic stress disorder. F1000 medicine reports, 2010. 2: p. 64.
Ruff, R.L., et al., A case–control study examining whether neurological deficits and PTSD in combat veterans are related to episodes of mild TBI. BMJ open, 2012. 2(2): p. e000312.
Ofek, H. and R. Defrin, The characteristics of chronic central pain after traumatic brain injury. Pain, 2007. 131(3): p. 330-340.
Riechers II, R.G., M.F. Walker, and R.L. Ruff, Post-traumatic headaches. Handbook of clinical neurology, 2015. 128: p. 567-578.
McCrea, M., Mild traumatic brain injury and postconcussion syndrome: The new evidence base for diagnosis and treatment. 2008: Oxford University Press.
Theeler, B.J. and J.C. Erickson, Mild head trauma and chronic headaches in returning US soldiers. Headache: The Journal of Head and Face Pain, 2009. 49(4): p. 529-534.
Cupini, L.M., P. Sarchielli, and P. Calabresi, Medication overuse headache: neurobiological, behavioural and therapeutic aspects. Pain, 2010. 150(2): p. 222-224.
Brennum, J., et al., Sumatriptan has no clinically relevant effect in the treatment of episodic tension‐type headache. European Journal of Neurology, 1996. 3(1): p. 23-28.
Silberstein, S.D., Practice parameter: Evidence-based guidelines for migraine headache (an evidence-based review)[RETIRED] Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 2000. 55(6): p. 754-762.
Burstein, R., B. Collins, and M. Jakubowski, Defeating migraine pain with triptans: a race against the development of cutaneous allodynia. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society, 2004. 55(1): p. 19-26.
Loder, E., Triptan therapy in migraine. New England Journal of Medicine, 2010. 363(1): p. 63-70.
Bigal, M.E. and R.B. Lipton, Excessive opioid use and the development of chronic migraine. PAIN®, 2009. 142(3): p. 179-182.
Huffman, J.C. and T.A. Stern, Neuropsychiatric consequences of cardiovascular medications. Dialogues in clinical neuroscience, 2007. 9(1): p. 29-45.
Garcia-Monco, J., et al., Impact of preventive therapy with nadolol and topiramate on the quality of life of migraine patients. Cephalalgia, 2007. 27(8): p. 920-928.
Holroyd, K.A., J.S. Labus, and B. Carlson, Moderation and mediation in the psychological and drug treatment of chronic tension-type headache: the role of disorder severity and psychiatric comorbidity. PAIN®, 2009. 143(3): p. 213-222.
Ponsford, J., et al., Impact of early intervention on outcome following mild head injury in adults. Journal of Neurology, Neurosurgery & Psychiatry, 2002. 73(3): p. 330-332.
Bove, G. and N. Nilsson, Spinal manipulation in the treatment of episodic tension-type headache: a randomized controlled trial. Jama, 1998. 280(18): p. 1576-1579.
Linde, K., et al., Acupuncture for migraine prophylaxis. Cochrane Database of Systematic Reviews, 2009(1).
Zanchin, G., et al., Self-administered pain-relieving manoeuvres in primary headaches. Cephalalgia, 2001. 21(7): p. 718-726.
Shekleton, J., et al., Sleep disturbance and melatonin levels following traumatic brain injury. Neurology, 2010. 74(21): p. 1732-1738.
Castriotta, R.J., et al., Prevalence and consequences of sleep disorders in traumatic brain injury. Journal of Clinical Sleep Medicine, 2007. 3(4): p. 349-356.
Lautenbacher, S., B. Kundermann, and J.-C. Krieg, Sleep deprivation and pain perception. Sleep medicine reviews, 2006. 10(5): p. 357-369.
