The Relationship Between Alcohol Consumption and Persistent Posttraumatic Headache After Mild Traumatic Brain Injury: A Single-Center Study

Traumatic brain injury (TBI) is a prevalent neurosurgical emergency that imposes a significant healthcare burden. Even mild TBI can lead to chronic headache. However, the relationship between posttraumatic headache and alcohol use remains unclear. This study is aimed at investigating the association between alcohol consumption and the development of persistent posttraumatic headache following mild TBI. Adult patients with mild TBI, treated between January 2023 and December 2023, were included. Follow-up interviews were conducted at least 6 months after hospital discharge. Logistic regression analysis was employed to adjust for baseline characteristics and other comorbidities. A total of 207 patients were analyzed, with an overall incidence of persistent posttraumatic headache of 36.2%. The regression analysis revealed an inverse relationship between alcohol consumption and persistent posttraumatic headache (OR: 0.355, 95% CI: 0.175, 0.717) after adjusting for confounding factors. This association remained unchanged after accounting for TBI- or headache-related alcohol avoidance (OR: 0.436, 95% CI: 0.212, 0.897). Female sex emerged as an independent risk factor for persistent posttraumatic headache (OR: 2.206, 95% CI: 1.107, 4.393). Other variables, including age, duration of hospital stay, in-hospital neurological symptoms, vomiting, sleep disorders, education level, and comorbidities, did not significantly affect the risk of persistent posttraumatic headache in the regression model. In conclusion, alcohol consumption is inversely associated with persistent posttraumatic headache in mild TBI patients. Although TBI- or headache-induced alcohol avoidance provides a plausible explanation for this inverse relationship, it may not fully account for the phenomenon. Female patients are at a higher risk of developing persistent posttraumatic headache after mild TBI. Further studies with low bias are needed to explore this relationship. Medical recommendations regarding alcohol consumption should be provided cautiously, considering the latest evidence, to inform patients with mild TBI about the potential risk of posttraumatic headache.