Treatment of Chronic Post-Traumatic Headache With OnabotulinumtoxinA

Headaches caused by trauma are called post-traumatic headaches (PTH). The Center for Disease
Control estimates that between 1.4 and 1.8 million civilians in the US sustain a traumatic
brain injury (TBI) each year. The objectives of the study will be evaluated in a civilian
population which has sustained a mild Traumatic Brain Injury (mTBI). Research has found that
the total cost due to headache in the US workforce is $20 billion per year, most of which is
in the form of reduce productivity while at work. For patients with TBI who are already
struggling with cognitive and health challenges in an effort to be productive, it seems
reasonable to suspect that chronic PTH may slow rehabilitation efforts and successful
re-entry into the work force and societal responsibility. Results from this study have the
potential to contribute to recommendations for treatment of chronic PTH.

Inclusion Criteria:

- Diagnosis of mild traumatic brain injury (mTBI) within the past 15 months

- Suffer at least fifteen total headache days per month

- Ability to speak and read English

Exclusion Criteria:

- Subject with hypersensitivity reactions or other intolerance to OnabotulinumtoxinA

- Previous use of OnabotulinumtoxinA for treatment of headache

- Any medications commonly used as headache preventives started less than 3 months prior
to enrollment

- Prior or current diagnosis of major psychiatric disorder or other central nervous
system disorder

- Less than 80% compliance (recorded for less than 24 days) in the 30 day screening
headache diary

- Subjects who are pregnant or trying to become pregnant within the timeframe of the
study