Finkel AG, et al. – This retrospective cohort study aimed to predict the probability of a military outcome (medical discharge/retirement) in patients with mild traumatic brain injury from a clinical analysis of predetermined patient and headache characteristics. After mild traumatic brain injury, certain headache characteristics appeared to be predictive of military outcomes, and the clinicians proposed a profile that could be useful in that prediction. To assess and treat patients with posttraumatic headache and to advise longer–term planning for the return to duty or discharge, these data were seen to be useful in future attempts.

• Between August 2008-January 2010, the physicians examined all new patients referred for headache evaluation at the Brain Injury Clinic of the Womack Army Medical Center, Ft. Bragg, NC.
• They extracted and examined headache characteristics.
• They conducted multivariable binary logistic regressions to predict the probability of medical discharge/retirement.

• In this study, 95 soldiers (age 31.3 ± 7.4 years, male 93.7%) reported 166 headaches.
• A blast was the most common injury cited (53.7%).
• Compared to patients without such a headache, patients with a continuous headache had almost 4 times the odds of a medically related discharge/retirement (continuous headache regression coefficient estimate: p < 0.042, odds ratio 3.98, 95% Wald confidence interval 1.05–15.07).
• Results recommended that patients with headache histories with severe holocephalic pain who medicate to keep functioning had the highest probability of medical discharge/retirement compared to service members who did not have a continuous headache.