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Abstract
“Posttraumatic” headaches claims are controversial because they are subjective reports often provided in the complex of litigation, and the underlying pathogenesis is not defined. This article reviews principles and scientific considerations in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) that should be noted by evaluators who examine such cases. Some examples in the AMA Guides, Sixth Edition, may seem to imply that mild head trauma can cause permanent impairment due to headache. The author examines scientific findings that present obstacles to claiming that concussion or mild traumatic brain injury is a cause of permanent headache. The World Health Organization, for example, found a favorable prognosis for posttraumatic headache, and complete recovery over a short period of time was the norm. Other studies have highlighted the lack of a dose-response correlation between trauma and prolonged headache complaints, both in terms of the frequency and the severity of trauma. On the one hand, scientific studies have failed to support the hypothesis of a causative relationship between trauma and permanent or prolonged headaches; on the other hand, non–trauma-related factors are strongly associated with complaints of prolonged headache.
- Abstract
- Scientific Findings Which Present Obstacles to Claiming That Concussion/Mild Traumatic Brain Injury is a Cause of Permanent Headache
- Scientific Findings Which Present Obstacles to Claiming That More Extensive Trauma is a Cause of Permanent Headache
- The Non-Permanent Nature of Posttraumatic Headache, When it Presents Outside of a Compensation/Litigation Context
- Non-Injury-Related Risk Factors for Persistent Headache Complaints
- The Unreliability of Examinee Claims of Injury-Relatedness
- Implications for Treatment, and for MMI Determination
- Implications for Impairment Evaluation
- Implications for Future Editions of the Guides
- References
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1
Carroll LJ, Cassidy JD. Prognosis for mild traumatic brain injury: Results of the WHO collaborating centre task force on mild traumatic brain injury. J Rehabil Med. 2004;Suppl. 43: 84-105.
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2
Berry H. Chronic whiplash syndrome as a functional disorder. Arch Neurol. 2000;57(4):592-94.
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Couch JR, Bearss C. Chronic daily headache in the posttrauma syndrome: relation to extent of head injury. Headache. 2001;41(6):559-64.
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Melhorn JM, Ackerman WE. Guides to the Evaluation of Disease and Injury Causation. Chicago, IL: American Medical Association; 2008
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Obelieniene D, et al. Pain after whiplash: a prospective controlled inception cohort study. J Neurol Neurosurg Psychiatry. 1999;66(3):279-83.
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Schrader H, et al. Natural evolution of late whiplash syndrome outside the medicolegal context. Lancet. 1996; 347(9010):1207-11.
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Mathew NT. Chronic refractory headache. Neurology. 1993;43(6 Suppl 3):S26-33.
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Warner JS, Fenichel, GM(1996). Chronic posttraumatic headache often a myth? Neurology. 1996; 46: 915-16.
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Levenson JL, ed. Textbook of Psychosomatic Medicine. Arlington, VA: American Psychiatric Publishing; 2005.
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10
Ropper AH, Brown RH. Adams and Victor's Principles of Neurology. 8th Ed. Burr Ridge, IL: McGraw-Hill Professional.
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11
Barsky AJ. Forgetting, fabricating, and telescoping: the instability of the medical history. Arch Intern Med, 2002;162(9):981-84.
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12
Don AS, Carragee EJ. Is the self-reported history accurate in patients with persistent axial pain after a motor vehicle accident? Spine J. 2009; 9(1):4-12.
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13
Lees-Haley PR, Williams CW, English LT. Response bias in self-reported history of plaintiffs compared with non-litigating patients. Psychological Rep. 79, p. 811-18.
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