Post-traumatic headache (PTH) may be considered a secondary headache, which is linked to severe disability and psychosocial impairment. Interestingly, nearly 30% of subjects with persistent post-traumatic headache (PPTH) also suffer from post-traumatic stress disorder (PTSD). Although existing studies demonstrated the existence of common pathophysiological characteristics in subjects with migraine and PPTH, the differences and similarities between these complex diseases are currently poorly understood and are yet to be comprehensively elucidated. Thus, the present review aimed to systematically investigate the nature of PPTH in the effort to better identify both the neurobiological and clinical aspects underlying this condition. Overall, the included studies reported that: (1) the predictors for persistent acute traumatic injury to the head were female gender, persistent symptoms related to mild post-traumatic brain injury (mTBI), PTSD, elevated inflammatory markers, prior mild traumatic brain injury, being injured while suffering from alcohol abuse; (2) static/dynamic functional connectivity differences, white matter tract abnormalities, and morphology changes were found between PPTH and migraine in brain regions involved in pain processing; and (3) clinical differences which were most prominent at early time points when they were linked to the increased risk of PPTH. Based on the selected reports, the relation between migraine and PPTH needs to be considered bidirectionally, but PTSD may play a critical role in this relation. The main implications of these findings, with a specific focus on PTSD, are discussed. Further longitudinal studies are needed to reveal the exact nature of this relation, as well as to clarify the distinct clinical characteristics of migraine, PPTH, and PTSD.

中文翻译：

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持久性创伤后头痛与创伤后应激障碍之间的关系：相似性和可能的​​差异。

创伤后头痛（PTH）可被认为是继发性头痛，与严重的残疾和社会心理障碍有关。有趣的是，近30％的持续性创伤后头痛（PPTH）受试者也患有创伤后应激障碍（PTSD）。尽管现有研究表明偏头痛和PPTH患者存在共同的病理生理特征，但目前对这些复杂疾病之间的差异和相似性了解甚少，尚待全面阐明。因此，本综述旨在系统地研究PPTH的性质，以期更好地确定这种情况的神经生物学和临床方面。总体而言，纳入研究报告：（1）头部持续急性外伤的预测指标是女性，与轻度颅脑外伤相关的持续症状，创伤后应激障碍，炎症标记升高，先前轻度脑外伤，酗酒者受伤; （2）在参与疼痛处理的大脑区域中，PPTH和偏头痛之间存在静态/动态功能连通性差异，白质束异常和形态变化；（3）在早期与PPTH风险增加相关的临床差异最为突出。根据选定的报告，偏头痛和PPTH之间的关系需要双向考虑，但是PTSD在这种关系中可能起关键作用。讨论了这些发现的主要含义，特别是PTSD。