Traumatic brain injury (TBI) is a prevalent, serious health problem with potentially long-lasting effects. Each year in the United States, 1.7 million people sustain a TBI that requires medical attention. Wars in the Middle East have led to more than 250,000 brain injuries among members of the military since 2000. Worldwide, TBI is the leading cause of chronic disability among young adults and children. Post-traumatic headache (PTH) is the most frequent symptom after a TBI.

Q. I need some advice. Over four years ago, I was thrown from my car, despite wearing a seatbelt, and landed on my head. I have read that most post-concussive headaches resolve within weeks or months. I, however, have had a headache all day, every day since the wreck. I have tried countless medications and treatments with little to no relief. Do you have any suggestions?

Headache disorders are prevalent, and while medical therapy provides relief to many headache sufferers, a significant number find their headaches unresponsive to treatment. One new therapy showing promise for such individuals is occipital nerve stimulation (ONS). A thorough review of this subject was included in the January issue of Therapeutic Advances in Neurological Disorders. This treatment has been used with migraine, cluster headache, hemicrania continua, cervicogenic headache, post-traumatic headache, occipital neuralgia and other headache disorders.

Headache after a traumatic brain injury is more common than previously understood, according to a recent study reported in the Journal of Neurotrauma. In the first year after injury, 71% percent of study participants reported headache, much higher than earlier studies have found. The findings were particularly pronounced for women, with 74% reporting headache in that year compared to 63% of men.

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