Headaches after Traumatic Brain Injury Highest in Adolescents and Girls

A recent study has been conducted by the Seattle Children’s Research Institute and appeared in Pediatrics, vol 129, number 1, January 2012, pages 1 to 9, titled Headache After Pediatric Traumatic Brain Injury: A Cohort Study, wirtten by Heidi K. Blume and et al.

The article discusses how in the adult population 18% to 33% of those who suffer from traumatic brain injury suffer from headaches 1 year after the injury.

In the child population most of the investigations conducted have been small, retrospective, lacked a control, or involved only short term follow up. Chronic headaches with children are associated with interference in social function, parental productivity, and poor quality of life.

The study randomly selected 1507 patients with TBI and 495 controls with arm injury (AI) for the study. However, some patients were not reachable, others were inegligible, and others refused. This left 512 patients with TBI and 137 with AIs for the study. Headache was reported by 43% of children with mild TBI and 37% of children with moderate/severe TBI, and 26% of the patients in the control group.

The authors noted that the frequency of serious headache appeared to be increased after mild TBI and in teenagers.

Twelve months after injury headache was reported for 41% children with mild TBI, 34% with moderate/severe TBI, and 34% of the patients in the control group.

Girls with mild TBI were found to have a higher prevalence of serious headache after 12 months than controls.

The study found that adolescents and girls had the highest frequency of headaches three months after injury.

The authors state

“The prevalence of migraine is associated with age and gender and is roughly equivalent in boys and girls until puberty when migraine prevalence begins to increase with age in girls, but not boys, reaching adult levels in late adolescence when migraine is much more common in girls than boys. We found a similar pattern of headache after mild TBI.”

Hence the authors speculate that the pathophysiology of posttraumatic headaches after mild TBI share similarities with the pathophysiology of migraine.

The authors did not label the headaches in this study according the the International Classification of Headache Disorders II criteria. I reference this criteia when discussing new daily persistent headache (NDPH) over at http://www.teethremoval.com/ndph.html and also in my limited amount of headaches listed in the headache guide over at http://www.teethremoval.com/headache.html.

In the conclusion of this study the authors state

“This study provides evidence that the response to and recovery from TBI is different in children, adolescents, and adults, and there are likely to be differences in symptoms of and recovery from TBI between boys and girls. Although only a fraction of children and adolescents with TBI develop chronic headaches related to their injury, because thousands of children sustain TBI each year, our findings indicate that many children and adolescents suffer from TBI associated headaches each year.”

Hence the results of this study may have implications for parents as girls and teenagers were found to be at the most increased risk for a headache after a mild TBI which could of course comes from a sports related injury. In some of the cases the headache may only last for a few weeks or months and most will recover after some time.

Dr. Heidi K. Blume has a list of SMART tips to help manage headaches in children and adolescents.

This stands for Sleep, Meals, Activity, Relation, and Trigger avoidance. Additional details can be found in the press release by Seattle Children’s Research Institute which is titled “Study Finds Headaches after Traumatic Brain Injury Highest in Adolescents and Girls” and written on December 5, 2011, and located over at http://www.seattlechildrens.org/Press-Releases/2011/Study-Finds-Headaches-after-Traumatic-Brain-Injury-Highest-in-Adolescents-and-Girls/

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