ABSTRACT
This chapter reviews the neurological, somatic, and emotional components of pain, primarily in persons who suffer comorbid head and body injuries on a nonsurgical level. If healing is incomplete, acute pain evolves into the chronic state, with changes in neurological functioning and multiple maladaptive effects upon level of performance and quality of life. Traumatic brain injury (TBI) results in a cascade of destructive events leading to impaired cellular function and destruction, including posttraumatic migraine headaches. The most common problem in adult patients being discharged after minor head injury and damage to the torso appears to be headaches, with incidence estimated at 30–80%. Posttraumatic headaches (PTH) incidence appears unrelated to the severity of the head trauma or evidence of TBI elicited by computed tomography or magnetic resonance imaging. PTH is usually accompanied by other concussion symptoms: depression and anxiety, dizziness; memory problems; weakness; nausea; numbness; diplopia; tinnitus; hearing problems; sexual problems, and often posttraumatic stress disorder.
