Increasing severity of traumatic brain injury is associated with an increased risk of subsequent headache or migraine: a retrospective cohort study of U.S. active duty service members, 2006-2015.

Traumatic brain injury (TBI) is a common injury in the U.S. Compared to the general population, military service members can be at increased risk for TBI because of the nature of their work. Sequelae of TBI, such as headache or migraine, can lead to military duty limitations or separation from service. To determine whether the severity of TBI is associated with the risk of these sequelae, this 2006-2015 retrospective cohort study compared the incidence of diagnosed headache or migraine among all service members with a first-time mild or moderate/severe TBI (N=111,018) against a matched sample without any history of TBI. Risk increased according to the severity of TBI. Compared to service members without TBI, those who sustained a mild TBI were 3.99 times more likely to have a headache or migraine, and those with a moderate/severe TBI were 8.89 times more likely. Patients, medical providers, and military leaders can use these results to guide care after a TBI. Early identification of those at higher risk of these sequelae could improve medical management and reduce disability.