Context: Post-traumatic headache (PTH) is a disabling headache disorder and the most common sequela of mild traumatic brain injury. The pathophysiology of PTH is poorly understood and there is limited available evidence to guide prophylactic medication selection. Emerging understanding of the pathophysiology of migraine headaches has led to the development of monoclonal antibodies, including erenumab. Erenumab has shown promise for the prevention of primary migraine headache; however, it has not yet been studied in PTH.

Case Series: five women (average age 43.0 ± 17.9y) received treatment with erenumab for PTH secondary to mTBI. The average duration of PTH prior to starting erenumab was 32.0 ± 18.2 months. All patients were taking at least one daily headache prophylactic therapy prior to erenumab. The average pre-erenumab headache intensity was 86/100. On erenumab, the average reported reduction in headache intensity was 51.1%. After starting erenumab, all five patients were able to discontinue one or more medication(s). The most common side effect was constipation (three patients). There were no serious adverse events after an average follow-up of 3.4 ± 1.5 months. One patient discontinued erenumab during this period of follow-up after the resolution of her headaches.

Conclusion: Erenumab appears to be safe and effective for the management of PTH.

背景：创伤后头痛 (PTH) 是一种致残性头痛疾病，是轻度创伤性脑损伤最常见的后遗症。PTH 的病理生理学知之甚少，指导预防性药物选择的可用证据有限。对偏头痛病理生理学的新认识导致了包括erenumab在内的单克隆抗体的开发。Erenumab 已显示出预防原发性偏头痛的前景。但是，它尚未在 PTH 中进行研究。

病例系列：五名女性（平均年龄 43.0 ± 17.9 岁）接受了 erenumab 治疗，以治疗继发于 mTBI 的 PTH。开始 erenumab 之前 PTH 的平均持续时间为 32.0 ± 18.2 个月。在erenumab 之前，所有患者每天至少接受一次头痛预防性治疗。平均 pre-erenumab 头痛强度为 86/100。在 erenumab 上，平均报告的头痛强度降低了 51.1%。在开始使用erenumab 后，所有五名患者都能够停用一种或多种药物。最常见的副作用是便秘（三名患者）。平均随访 3.4 ± 1.5 个月后未发生严重不良事件。一名患者在头痛消退后的这段随访期间停止使用erenumab。

结论：Erenumab 似乎对 PTH 的管理是安全有效的。