Similarities and Differences in Experiences of US Veterans with Cluster Headache, Post-traumatic Headache and Migraine: Findings from 59 Qualitative Interviews
Karolina Schantz1, Rikki Mangrum1, Charis Yousefian1, Daniel Rogers2, Elizabeth Seng3, Laura Burrone2, Jason Sico2
1Vector Psychometric Group, 2Headache Centers of Excellence, Veterans Health Administration, 3Headache Centers of Excellence, Veterans Health Administration, Yeshiva University, Albert Einstein College of Medicine
Objective:

This qualitative study aims to understand the lived experiences of U.S. military veterans with cluster headache, post-traumatic headache (PTHA), and migraine and identify similarities and differences in symptoms, functional impacts, and emotional burden.

Background:

Existing research into headache-related experiences has overwhelmingly focused on female samples and migraine. A better understanding of cluster headache and PTHA is needed to inform clinical outcomes measurement and healthcare delivery. A study of veterans allows for input from more male participants and those experiencing cluster headache and PTHA.

Design/Methods:

The research team conducted in-depth, 90-minute interviews, from September 2024 through May 2025, with 19 veterans with migraine, 20 with cluster headache and 20 with PTHA who received care through the Veterans Health Administration. Interviews were recorded and transcribed verbatim. Transcripts were coded using NVivo qualitative analysis software. Researchers used content and thematic analysis to identify concepts and patterns in the data.

Results:

Many commonalities in participants’ experience across headache conditions emerged, despite differences in symptom profiles. Participants across headache types described visual disturbances, photophobia, phonophobia, brain fog, fatigue, and experienced premonitory headache, but differed in cranial autonomic parasympathetic symptoms, headache duration, and speed of onset. Impacts on physical, cognitive, and psychosocial functioning were similar across headache types. Cognitive impacts, while most severe for PTHA, were common for all participants. Irritability was also common and negatively impacted family and social roles. Participants also highlighted emotional burden, describing sadness, depression, and anxiety related to their headaches.

Conclusions:

While there are differences in disease profiles between cluster headache, migraine, and PTHA, individuals with these conditions experience similar emotional and functional impacts. These findings suggest avenues for enhancing care planning and outcome evaluation for people with headache such as integrating neurology and mental health services and improving assessment of cognitive and social impacts.

10.1212/WNL.0000000000215625
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.