Purpose of Review

To discuss the treatment of post-traumatic headache (PTH) and how to choose pharmacotherapy based upon known pathophysiology.

Recent Findings

Preclinical models of traumatic brain injury are finally revealing some of the mechanisms of PTH, including the significant role that inflammatory neuropeptides like calcitonin gene-related peptide (CGRP) play in the initiation and persistence of symptoms.

Summary

To effectively treat post-traumatic headache (PTH), one needs to understand the pathophysiology behind the initiation and persistence of symptoms. Recent animal models are starting to elucidate these mechanisms, but effective treatment will also likely rely on the identification of patients who are most at risk for persistent PTH. Trials of early, targeted therapy for at-risk patients will be needed to validate these hypotheses. Additionally, high powered clinical trials are lacking in the field of persistent PTH for medications that are known to be effective in primary headache disorders. Effective treatment for persistent PTH also requires understanding how headache interacts with the complex nature of persistent post-concussion symptoms, as this disease often necessitates a multi-disciplinary approach. Regardless, with the knowledge gained by new PTH models cited in this paper, and an increasing availability of novel headache medications, more effective treatment models are on the horizon.

中文翻译：

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治疗创伤后头痛的模型

审查目的

讨论创伤后头痛（PTH）的治疗以及如何根据已知的病理生理学选择药物治疗。

最近的发现

创伤性脑损伤的临床前模型最终揭示了 PTH 的一些机制，包括降钙素基因相关肽 (CGRP) 等炎症神经肽在症状的发生和持续中发挥的重要作用。

概括

为了有效治疗创伤后头痛 (PTH)，人们需要了解症状发生和持续背后的病理生理学。最近的动物模型开始阐明这些机制，但有效的治疗也可能依赖于识别最有可能发生持续性 PTH 的患者。需要对高危患者进行早期靶向治疗试验来验证这些假设。此外，在持久性 PTH 领域缺乏已知对原发性头痛有效的药物的高效临床试验。持续性 PTH 的有效治疗还需要了解头痛如何与持续性脑震荡后症状的复杂性质相互作用，因为这种疾病通常需要多学科治疗。无论如何，随着本文引用的新 PTH 模型获得的知识，以及新型头痛药物的不断增加，更有效的治疗模型即将出现。