It is well known that headache is one of the most common debilitating chronic pain conditions in patients who sustain a mild traumatic brain injury (mTBI). No conventional pharmacological treatment has been shown to be effective in treating headaches related to traumatic brain injury (TBI). I recently read an interesting abstract published in Pain Physician; 19(2)(E 34754)- entitled rTMS in Alleviating Mild TBI Related Headaches – A Case Series.

In this study, the authors designed a perspective evaluation in patients with established diagnoses of mild traumatic brain injury related headaches who were treated with neuronavigational guided rTMS. The study was conducted at the Veterans Administration San Diego Health Care System, where over 400 patients with mTBI are evaluated annually.

The study included six men (average age of 50) with mTBI-HA. Constant headaches were rated at 4 on a 0-10 numerical rating pain scale (NRPS) and all patients were on stable headache medication regiments. Each of the patients received 4 sessions of rTMS over a 2 month period.

Following the treatment, the patients were again evaluated. The average post rTMS headache intensity was reduced by 53.05%. The average headache exacerbation frequency per week was reduced by approximately 79% with 2 patients reporting complete cessation of severe headache episodes.

The authors concluded that rTMS offered a “non-evasive” treatment option for MTBI-HA.

(Pain Physician. 2016 Feb;19(2):E347-54. rTMS in Alleviating Mild TBI Related Headaches – A Case Series)