Posttraumatic headache: a review.

There has been intense controversy about postconcussion syndrome (PCS) since Erichsen's publication in 1866 on railway brain and spine. Headache as a result of trauma is one of the most common secondary headache types. Posttraumatic headache (PTH) remains a very controversial disorder, particularly with relation to chronic PTH following mild closed-head injury. PTH is one of several symptoms of PCS, and therefore may be accompanied by additional cognitive, behavioral, and somatic problems. PTH also is an important public health issue due to its associated disability and often refractory clinical course. While current awareness of PTH has become more prominent due to increased scrutiny given to both combat-related and sports-related head injuries, directed treatment remains a difficult challenge for physicians. Because of the frequently associated medicolegal aspects, PTH is one of physicians' least favorite types to treat. The article reviews both PCS and PTH.