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Headaches Take Toll On Soldiers | Health

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Headaches Take Toll On Soldiers
Headaches Take Toll On Soldiers

The following information was sent to us by The Media Relations Department at Johns Hopkins Medicine:

Troops evacuated from Iraq and Afghanistan with headaches unlikely to return to duty; heavy helmets a major factor

Headaches, a virtually universal human complaint at one time or another, are among the top reasons for medical evacuation of military personnel from Iraq and Afghanistan, and for ongoing depletion of active-duty ranks in those countries, according to research led by Johns Hopkins specialists. Just one-third of soldiers sent home because of headaches return to duty in either place, the research shows. 

The findings, published online in Cephalalgia, the journal of the International Headache Society, highlight one of the fastest-growing causes of medical evacuations from the two prolonged military conflicts. 

Overall, neurological illness is one of the top three causes of non-combat-related loss of unit strength in Operations Iraqi Freedom and Enduring Freedom, and headaches are the most common neurological complaint in the war zones. Cohen and his team found that post-concussion headaches and migraines were the most common forms of headache requiring evacuation. Physical trauma led to almost half of the debilitating headaches, they determined.

Cohen says a significant number of headaches were the result of damage to or pressure on the occipital nerve, located in the back of the head. This is often caused by the heavy Kevlar helmets soldiers are required to wear on patrol and for long periods. 

The study results emerged when Cohen and his colleagues reviewed the medical records of all 985 military personnel — roughly one in 1,000 soldiers deployed in the regions — medically evacuated from Iraq and Afghanistan between 2004 and 2009 with a primary diagnosis of headache. This did not include those evacuated primarily for other reasons (trauma, for example) who suffered headaches as a consequence. 

Some 67 percent never returned to the war zone, the researchers found. Those most likely to return were officers, whose jobs are often less physically taxing, and women, who rarely have combat roles. 

Only one in five of those whose headaches were associated with physical trauma, such as post-concussion headaches, returned to duty, while nearly half of those who were evacuated with tension headaches went back to the war zone. 

For those headache sufferers who also had a diagnosis of a psychiatric illness or traumatic brain injury, the return to duty rate was among the lowest. Those whose headaches were treated with narcotic pain killers were also far less likely to return to work in a war zone.

The study was funded by the John P. Murtha Neuroscience and Pain Institute, the U.S. Army and the Army Regional Anesthesia and Pain Medicine Initiative.

Other Johns Hopkins researchers involved with the study include Artemus Flagg II, M.D., and Sam M. Galvagno Jr., D.O.


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