Anatomy of a Headache

Dr. Robbins Free Medical
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Long-Acting Opioids for
Refractory Chronic

Study results for a group
of difficult-to-treat
migraineurs provide a
basis for determining
efficacy and guidelines
for the use of long-term
opioids in this


Heatherís Chronic
Migraine: an Interactive
Case History

This column will take you,
step by step, through
the diagnosis of a complex
headache patient with
the pseudonym of "Heather."



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Incidence of Headache and Severity of Head Injury
Michio Yamaguchi, MD
Posted: January 2010
Headache  1992;32:427-431

The relationship between the incidence of post-traumatic headache and the severity of head injury has been a controversial issue. The milder the head injury, the more frequently severe headache is noted as a symptom. To investigate this relationship, 121 civilians were investigated using simplified classifications of the grade of headache, type of injury (mild or severe), cervical X-ray and head CT findings, and clinical history. All the subjects were claiming compensation for work-related injuries.

In the mildly injured group, 46/64 patients complained of severe headache, while only 19/57 had severe headache in the severely injured group. Abnormal findings on the cervical X-ray films including degenerative changes were more frequent in the severe headache group. CT abnormalities correlated positively with the severity of head injury, but showed an inverse relationship with the incidence of headache. Mentally impaired patients also complained of headache less frequently. On the basis of these results, possible organic mechanisms related to the pathogenesis of post-traumatic headache are discussed.

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