CDE Detailed Report
Subdomain Name: History of Disease/Injury Event
CRF: files
Displaying 1 - 50 of 52
CDE ID | CDE Name | Variable Name | Definition | Short Description | Question Text | Permissible Values | Description | Data Type | Disease Specific Instructions | Disease Specific Reference | Population | Classification (e.g., Core) | Version Number | Version Date | CRF Name (CRF Module / Guidance) | Subdomain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | External Id Loinc | External Id Snomed | External Id caDSR | External Id CDISC |
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C59636 | Headache associated symptom type frequency category | HdchAssocSymptmTypFreqCat | Category that describes how frequently the headache associated symptom type effects the participant/subject | Category that describes how frequently the headache associated symptom type effects the participant/subject | Did the individual experience the following symptoms during headache | Never;Almost Never;Sometimes;Often;Almost always | Never;Almost Never;Sometimes;Often;Almost always | Alphanumeric |
Choose one |
Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 21:12:27.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59679 | Sound sensitive without headache indicator | SoundSensitvWthoutHdchInd | Indicator of whether participant/subject experienced sensitivity to sound without a headache | Indicator of whether participant/subject experienced sensitivity to sound without a headache | Sensitivity to sound | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:34:58.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59658 | Relative biological first degree diagnosis headache history indicator | RelatvBioFrstDegrDxHxHdchInd | Indicator of whether first-degree biological relatives of the participant/subject has a history of diagnosed headache | Indicator of whether first-degree biological relatives of the participant/subject has a history of diagnosed headache | First Degree Biological Relative? | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 21:54:17.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C15961 | Headache worse during activity indicator | HeadachWorsDurngActvtyInd | Indicates whether activity or playing makes headache worse | Indicates whether activity or playing makes headache worse | Headaches worse with physical activity | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59669 | Headache before traumatic brain injury monthly frequency | HdchBfrTBIMnthFreq | Frequency of monthly headaches the participant/subject experienced prior to traumatic brain injury | Frequency of monthly headaches the participant/subject experienced prior to traumatic brain injury | Prior to the TBI, how many days per month (30 days) did the individual have a headache of any duration (minutes or hours) of any severity (mild, moderate or severe)? | 0;1;2;3;4;5;6;7;8;9;10;11;12;13;14;15;16;17;18;19;20;21;22;23;24;25;26;27;28;29;30 | 0;1;2;3;4;5;6;7;8;9;10;11;12;13;14;15;16;17;18;19;20;21;22;23;24;25;26;27;28;29;30 | Numeric Values |
Indicate number of days |
Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:15:11.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59637 | Headache additional symptom type | HdchAddtnlSymptmTyp | Type of additional symptoms the participant/subject experienced with headache | Type of additional symptoms the participant/subject experienced with headache | Headache Symptom | Miosis (i.e., excessive constriction of the pupil of the eye);Aural fullness (i.e., stuffy ears or fluid in the ears);Conjunctival Injection (i.e., white of eye gets red);Tearing;Nasal congestion;Eyelid swelling;Eyelid drooping;Facial sweating | Miosis (i.e., excessive constriction of the pupil of the eye);Aural fullness (i.e., stuffy ears or fluid in the ears);Conjunctival Injection (i.e., white of eye gets red);Tearing;Nasal congestion;Eyelid swelling;Eyelid drooping;Facial sweating | Alphanumeric |
Choose all that apply |
Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 21:13:24.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
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C59680 | Neck pain stiffness without headache indicator | NeckPainStffnssWthoutHdchInd | Indicator of whether participant/subject experienced neck pain/stiffness without a headache | Indicator of whether participant/subject experienced neck pain/stiffness without a headache | Neck Pain/Stiffness | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:35:53.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59659 | Headache before traumatic brain injury history indicator | HdchBfrTBIHxInd | Indicator of whether the participant/subject had experienced headaches prior to traumatic brain injury | Indicator of whether the participant/subject had experienced headaches prior to traumatic brain injury | Headaches prior to TBI | No;Yes | No;Yes | Alphanumeric |
If 'NO', then questionnaire is complete |
Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 21:58:17.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C15972 | Headache aura symptom type | HdchAurasSymTyp | Type of aura (warning) that a headache was going to start | Type of aura (warning) that a headache was going to start | Aura | Visual;Sensory;Speech and/or Language;Motor;Brainstem;Retinal;Other, specify | Visual;Sensory;Speech and/or Language;Motor;Brainstem;Retinal;Other, specify | Alphanumeric |
Choose all that apply |
Adult;Pediatric | Supplemental | 3.10 | 2023-08-14 20:18:35.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
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C59670 | Headache mild before traumatic brain injury average monthly frequency | HdchMildBfrTBIAvgMnthFreq | Average monthly frequency of headaches the participant/subject experienced with mild severity prior to traumatic brain injury | Average monthly frequency of headaches the participant/subject experienced with mild severity prior to traumatic brain injury | Prior to the TBI, what was the average monthly headache frequency of any kind with mild severity | 0;1;2;3;4;5;6;7;8;9;10;11;12;13;14;15;16;17;18;19;20;21;22;23;24;25;26;27;28;29;30 | 0;1;2;3;4;5;6;7;8;9;10;11;12;13;14;15;16;17;18;19;20;21;22;23;24;25;26;27;28;29;30 | Numeric Values |
Indicate average number of days |
Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:17:56.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59638 | Headache additional symptom type present indicator | HdchAddtnlSympTypPresentInd | Indicator of whether the participant's/subject's headache symptom is present | Indicator of whether the participant's/subject's headache symptom is present | Is Symptom Present? | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 21:15:53.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59681 | Dizziness vertigo without headache indicator | DizzinessVertigoWthoutHdchInd | Indicator of whether participant/subject experienced dizziness and/or vertigo without a headache | Indicator of whether participant/subject experienced dizziness and/or vertigo without a headache | Dizziness and/or vertigo | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:36:54.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59660 | Headache prior diagnosis indicator | HdchPriorDxInd | Indicator of whether the participant/subject had a prior headache diagnosis | Indicator of whether the participant/subject had a prior headache diagnosis | Does patient have a prior headache diagnosis? | Yes;No | Yes;No | Alphanumeric |
If 'YES' then answer the following questions regarding characteristics of pre-TBI headaches |
Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 21:59:21.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C16207 | Family history medical condition first-degree relative type | FamHistMedclCondFrstDegReltTyp | Relationship of the first-degree family member or ancestor with the medical condition or health related event to the participant/subject | Relationship of the first-degree family member or ancestor with the medical condition or health related event to the participant/subject |
Relationship of first-degree relative(s) to participant/subject |
1;2;3;4;5;6;7;8;9;10 | Biological Mother;Biological Father;Sibling Male;Sibling Female;Non-identical or dizygotic twin Male;Non-identical or dizygotic twin Female;Identical twin Male;Identical twin Female;Full biologic child Male;Full biologic child Female | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
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C59671 | Headache moderate before traumatic brain injury average monthly frequency | HdchModrtBfrTBIAvgMoFreq | Average monthly frequency of headaches the participant/subject experienced with moderate severity prior to traumatic brain injury | Average monthly frequency of headaches the participant/subject experienced with moderate severity prior to traumatic brain injury | Prior to the TBI, what was the average monthly headache frequency of any kind with moderate severity | 0;1;2;3;4;5;6;7;8;9;10;11;12;13;14;15;16;17;18;19;20;21;22;23;24;25;26;27;28;29;30 | 0;1;2;3;4;5;6;7;8;9;10;11;12;13;14;15;16;17;18;19;20;21;22;23;24;25;26;27;28;29;30 | Numeric Values |
Indicate average number of days |
Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:20:31.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59639 | Headache additional symptom laterality type | HdchAddtnlSympLateralTyp | Laterality type of the participant's/subject's headache symptom | Laterality type of the participant's/subject's headache symptom | If 'Yes', is Symptom Unilateral or Bilateral? | Unilateral;Bilateral | Unilateral;Bilateral | Alphanumeric |
Choose one |
Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 21:17:24.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59682 | Gait posture imbalance without headache indicator | GaitPostrImbalncWthoutHdchInd | Indicator of whether participant/subject experienced gait and/or postural imbalance without a headache | Indicator of whether participant/subject experienced gait and/or postural imbalance without a headache | Gait and/or postural imbalance | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:38:30.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59661 | Headache prior diagnosis type | HdchPriorDxTyp | Type of prior headache history diagnosis | Type of prior headache history diagnosis | If 'Yes', please check all that apply | Migraine with aura;Migraine without aura;Chronic Migraine;Other;Episodic cluster headache;Chronic cluster headache;Cervicogenic headache;Infrequent episodic tension-type headache;Frequent episodic tension-type headache;Chronic tension-type headache | Migraine with aura;Migraine without aura;Chronic Migraine;Other;Episodic cluster headache;Chronic cluster headache;Cervicogenic headache;Infrequent episodic tension-type headache;Frequent episodic tension-type headache;Chronic tension-type headache | Alphanumeric |
Choose all that apply; Only answer if 'YES' is answered to "Does patient have a prior headache diagnosis?" |
Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:00:18.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
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C16208 | Family history medical condition second-degree relative type | FamHistMedclCondScndDegReltTyp | Relationship of the second-degree family member or ancestor with the medical condition or health related event to the participant/subject | Relationship of the second-degree family member or ancestor with the medical condition or health related event to the participant/subject | Relationship of second-degree relative(s) to participant/subject | 11;12;13;14;15;16;17;18;19;20;21;22;23;24 | Half-Sibling Male;Half-Sibling Female;Maternal Grandmother;Maternal Grandfather;Paternal Grandmother;Paternal Grandfather;Maternal Aunt;Maternal Uncle;Paternal Aunt;Paternal Uncle;Grandchild Male;Grandchild Female;Nephew;Niece | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
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C59672 | Headache severe before traumatic brain injury average monthly frequency | HdchSevereBfrTBIAvgMoFreq | Average monthly frequency of headaches the participant/subject experienced with severe severity prior to traumatic brain injury | Average monthly frequency of headaches the participant/subject experienced with severe severity prior to traumatic brain injury | Prior to the TBI, what was the average monthly headache frequency of any kind with severe severity | 0;1;2;3;4;5;6;7;8;9;10;11;12;13;14;15;16;17;18;19;20;21;22;23;24;25;26;27;28;29;30 | 0;1;2;3;4;5;6;7;8;9;10;11;12;13;14;15;16;17;18;19;20;21;22;23;24;25;26;27;28;29;30 | Numeric Values |
Indicate average number of days |
Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:21:35.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59640 | Headache additional symptom unilateral same side present indicator | HdchAddtnlSympUnilatSmSdPrsInd | Indicator of whether the participant's/subject's symptom is present on the same side to the headache | Indicator of whether the participant's/subject's symptom is present on the same side to the headache | If 'Unilateral', is Symptom Present on Same Side to Headache? | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 21:18:48.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59683 | Memory concentration difficult without headache indicator | MemCncntrnDffcltWthoutHdchInd | Indicator of whether participant/subject experienced difficulty with memory/concentration without a headache | Indicator of whether participant/subject experienced difficulty with memory/concentration without a headache | Difficulty with memory/concentration | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:39:26.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59662 | Headache prior diagnosis type other text | HdchPriorDxTypOTH | The free-text field related to 'Headache prior diagnosis type' specifying other text | The free-text field related to 'Headache prior diagnosis type' specifying other text | Other | Alphanumeric |
Only answer if 'YES' is answered to "Does patient have a prior headache diagnosis?" |
Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:02:58.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events | 255 |
Free-Form Entry |
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C19035 | Headache aura symptom other text | HdchAurasSymOTH | The free-text field related to 'Headache aura symptom type' specifying other text. Type of aura (warning) that a headache was going to start | The free-text field related to 'Headache aura symptom type' specifying other text. Type of aura (warning) that a headache was going to start | Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.10 | 2023-08-14 20:18:00.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events | 4000 |
Free-Form Entry |
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C59673 | Headache before traumatic brain injury complete freedom monthly day count | HdchBfrTBICmplFreeMnthDyCt | Count of monthly frequency of complete freedom from headache the participant/subject experienced prior to traumatic brain injury | Count of monthly frequency of complete freedom from headache the participant/subject experienced prior to traumatic brain injury | Prior to the TBI, how many days per month (30 days) did the individual have complete headache freedom | 0;1;2;3;4;5;6;7;8;9;10;11;12;13;14;15;16;17;18;19;20;21;22;23;24;25;26;27;28;29;30 | 0;1;2;3;4;5;6;7;8;9;10;11;12;13;14;15;16;17;18;19;20;21;22;23;24;25;26;27;28;29;30 | Numeric Values |
Indicate number of days |
Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:22:26.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59641 | Headache aura occurrence indicator | HdchAuraOccurInd | Indicator of whether the participant/subject has an aura occur with headache | Indicator of whether the participant/subject has an aura occur with headache | Auras with headaches | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 21:22:36.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59684 | Aura without headache indicator | AuraWthoutHdchInd | Indicator of whether participant/subject experienced an aura without a headache | Indicator of whether participant/subject experienced an aura without a headache | Aura without headache | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:41:46.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59663 | Headache first date | HdchFirstDate | Date of the participant's/subject's first headache | Date of the participant's/subject's first headache | Date of first headache | Date or Date & Time |
Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.). |
ISO 8601 - https://www.iso.org/iso-8601-date-and-time-format.html | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:06:19.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
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C59630 | Headache laterality anatomic site | HdchLateralAnatSite | Anatomic site location of the headache | Anatomic site location of the headache | Where were the headaches usually located? | Right;Left;Front;Back;Top;Side/Temples | Right;Left;Front;Back;Top;Side/Temples | Alphanumeric |
Choose all that apply |
Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 21:04:11.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
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C59674 | Headache before traumatic brain injury continuous indicator | HdchBfrTBICntInd | Indicator of whether headaches experienced by the participant/subject were continuous prior to traumatic brain injury | Indicator of whether headaches experienced by the participant/subject were continuous prior to traumatic brain injury | Were headaches prior to the TBI continuous (i.e., no periods of headache freedom) | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:23:51.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59642 | Headache aura symptom type frequency category | HdchAuraSympTypFreqCat | Category that describes how the aura symptom type effects the participant/subject | Category that describes how the aura symptom type effects the participant/subject | Did the individual experience the following aura types with headaches | Never;Almost Never;Sometimes;Often;Almost always | Never;Almost Never;Sometimes;Often;Almost always | Alphanumeric |
Choose one |
Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 21:24:09.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59664 | Headache after traumatic brain injury change indicator | HdchAftrTBIChngInd | Indicator of whether the participant's/subject's headaches after a traumatic brain injury changed followingf the TBI | Indicator of whether the participant's/subject's headaches after a traumatic brain injury changed followingf the TBI | Did the headache that was present prior to TBI change following TBI? | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:07:34.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59631 | Headache laterality type | HdchLateralTyp | Type of side were headache is located | Type of side were headache is located | What side(s) was the headache(s) usually on | Right only;Left only;Both sides;Alternating sides | Right only;Left only;Both sides;Alternating sides | Alphanumeric |
Choose all that apply |
Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 21:06:04.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
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C59675 | Headache before traumatic brain injury noncontinuous inadequate treatment duration | HdchBfrTBINnctnInadqTxDur | Duration of participant/subject's inadequately treated noncontinuous headache | Duration of participant/subject's inadequately treated noncontinuous headache | If headaches were not continuous, how long did headaches last if untreated/inadequately treated? | Numeric Values |
Duration is recorded in hours and minutes (HH:MM) |
Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:24:45.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
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C59643 | Headache aura experience percent value | HdchAuraExprncPctVal | Value of (the percentage of) headaches the participant/subject experience with auras | Value of (the percentage of) headaches the participant/subject experience with auras | Percentage of headaches experienced with auras | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 21:25:45.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
0 | 100 | percent | |||||||||
C15897 | Headache associated symptom type | HdchAssocSymptmTyp | The associated symptoms the participant/subject experienced with headache | Type of symptoms associated with the headache | Symptom | Nausea;Vomiting;Sensitive to light;Sensitive to noise;Neck Pain/Stiffness;Dizziness and/or vertigo;Gait and/or postural imbalance;Difficulty with memory/concentration | Nausea;Vomiting;Sensitive to light;Sensitive to noise;Neck Pain/Stiffness;Dizziness and/or vertigo;Gait and/or postural imbalance;Difficulty with memory/concentration | Alphanumeric |
Choose all that apply |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
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C59665 | Headache after traumatic brain injury intensity change indicator | HdchAfterTBIIntnseChngInd | Indicator of whether the participant/subject is experiencing more intense headaches following traumatic brain injury | Indicator of whether the participant/subject is experiencing more intense headaches following traumatic brain injury | Are headaches more intense following TBI? | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:10:06.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59632 | Headache maximum pain intensity scale | HdchMaxPainIntstyScl | Rating scale of the maximum headache pain intensity described by the participant/subject | Rating scale of the maximum headache pain intensity described by the participant/subject | Maximum headache pain intensity: 0 (no pain) to 10 (most severe pain) scale | 0;1;2;3;4;5;6;7;8;9;10 | 0;1;2;3;4;5;6;7;8;9;10 | Numeric Values |
"0" = no pain and "10" = most severe pain |
Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 21:07:20.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59676 | Nausea without headache indicator | NausWthoutHdchInd | Indicator of whether participant/subject experienced nausea without a headache | Indicator of whether participant/subject experienced nausea without a headache | Nausea | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:31:29.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59655 | Headache category | HeadacheCat | Type of headache experienced by the participant/subject | Type of headache experienced by the participant/subject | Headache Type | Migraine;Post Traumatic Headache;Other Headache | Migraine;Post Traumatic Headache;Other Headache | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 21:50:50.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
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C15917 | Headache typical pain intensity rate scale | HeadacheTypPainIntstyRateScl | Rating scale for the pain of this headache on a scale of 0 -10 | Rating scale for the pain of this headache on a scale of 0 -10 | Typical headache pain intensity: 0 (no pain) to 10 (most severe pain) scale | 0;1;2;3;4;5;6;7;8;9;10 | 0;1;2;3;4;5;6;7;8;9;10 | Numeric Values |
"0" = no pain and "10" = most severe pain |
Adult;Pediatric | Supplemental | 4.10 | 2023-06-02 10:23:14.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59666 | Headache after traumatic brain injury frequency change indicator | HdchAfterTBIFreqChngInd | Indicator of whether the participant/subject is experiencing more frequenct headaches following traumatic brain injury | Indicator of whether the participant/subject is experiencing more frequenct headaches following traumatic brain injury | Are headaches more frequent following TBI? | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:11:06.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59634 | Headache worse with neck movement indicator | HdchWorseWthNeckMvmtInd | Indicator of whether the subject's/participant's headaches worsen with neck movements | Indicator of whether the subject's/participant's headaches worsen with neck movements | Headaches worse with neck movements | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 21:10:43.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59677 | Vomit without headache indicator | VomitWthoutHdchInd | Indicator of whether participant/subject experienced vomiting without a headache | Indicator of whether participant/subject experienced vomiting without a headache | Vomiting | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:32:32.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59656 | Headache category other text | HeadacheCatOTH | The free-text field related to 'Headache category' specifying other text | The free-text field related to 'Headache category' specifying other text | Other Headache Type | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 21:52:09.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events | 255 |
Free-Form Entry |
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C15937 | Headache typical severity type | HeadachTypclSevertyTyp | Level of headache intensity described by the participant/subject | Level of headache intensity described by the participant/subject | Intensity | Mild;Moderate;Severe | Mild;Moderate;Severe | Alphanumeric |
Choose one |
Adult;Pediatric | Supplemental | 3.10 | 2023-08-14 08:41:42.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59667 | Headache after traumatic brain injury symptom change indicator | HdchAfterTBISympChngInd | Indicator of whether the participant's/subject's headaches symptoms changed following traumatic brain injury | Indicator of whether the participant's/subject's headaches symptoms changed following traumatic brain injury | Are headaches associated with new characteristics (e.g., changes in quality, location, or 'associated symptoms' i.e., nausea, vomiting, dizziness, vertigo, or photophobia) following TBI? | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:13:08.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59635 | Headache worse with mental activity indicator | HdchWorseWthMentalActvInd | Indicator of whether the subject's/participant's headaches worsen with mental activity | Indicator of whether the subject's/participant's headaches worsen with mental activity | Headaches worse with mental activity (e.g., reading, concentration) | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 21:11:41.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59678 | Light sensitive without headache indicator | LightSensitvWthoutHdchInd | Indicator of whether participant/subject experienced sensitivity to light without a headache | Indicator of whether participant/subject experienced sensitivity to light without a headache | Sensitivity to light | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 22:33:42.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C59657 | Headache type family history indicator | HeadacheTypFamHxInd | Indicator as to whether the participant/subject has a family history of diagnosed headache type | Indicator as to whether the participant/subject has a family history of diagnosed headache type | Family History of Headache Type? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2023-08-14 21:53:18.0 | Post-traumatic Headache (PTH) - Headaches Prior to TBI Questionnaire | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |