[On the so-called posttraumatic headache (author's transl)].

Following an introduction on the notion of posttraumatic headache and on the etiology and pathogenesis of headache occurring after head injuries, the author discusses in detail the clinical aspects of such pain. Especially, a description of headache that can be expected in different types of head injury and posttraumatic complication, is presented. The importance of differential diagnosis of cephalea originating in the vertebro-cervical region and of atraumatic headache occurring casually some time after a head injury, is stressed. In the author's view, genuine chronic posttraumatic cephalea exists only in very rare cases and is always associated with considerable organic intracranial lesions. As to treatment, long-standing continuous medication with analgesics is strictly rejected. The usual therapeutic measures are mentioned and judged critically. For prophylaxis of chronic headache following head injuries, adequate primary treatment, early mobilization and early return to occupational activity seem most important. Long-lasting confinement to bed in the absence of objective clinical signs is considered as one the causes of obstinate cephalea after head injuries which are frequently only minor in degree. If psychoneurotic fixation of the accident sets in, psychiatric treatment should be commenced immediately as to prevent the establishment of irreversible neurotic symptoms. For the same reason, a pending procedure for recompensation should be settled as soon as possible. Observing the therapy explained, including guidance of patients, the prognosis of headache following head injuries proves on the whole to be very favourable.