Demographics and Treatment of Adolescent Posttraumatic Headache in a Regional Concussion Clinic

Bramley, Harry; Heverley, Steven R.; Lewis, Mechelle M.; Kong, Lan; Rivera, Rowena; Silvis, Matthew

doi:10.1016/j.pediatrneurol.2015.01.008

Cited by 35 publications

(21 citation statements)

References 44 publications

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“…The other RCT evaluated collaborative care, including advocacy and coordination with schools regarding accommodations and motivational interviewing, cognitive–behavioural therapy (CBT) and psychopharmacological consultation 24. Other treatments that reported positive effects included a physiotherapy programme,25 26 cognitive therapies,27 medical treatments using amitriptyline,28 amantadine,29 peripheral nerve blocks (including greater occipital nerve blocks)30 and exercise interventions including submaximal aerobic training in children31 32 and adults 33–36. Individuals who performed the greatest activity level were found to have worse performance in visual memory, but not other cognitive domains, in one study 37.…”

Section: Resultsmentioning

confidence: 99%

Rest and treatment/rehabilitation following sport-related concussion: a systematic review

et al. 2017

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Section: Resultsmentioning

confidence: 99%

Rest and treatment/rehabilitation following sport-related concussion: a systematic review

et al. 2017

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“…However, an earlier pediatric study of symptoms following sports‐related concussion found no gender differences in the reporting of PCS and PTH 22 . In a study of 400 patients from a pediatric concussion clinic, although 90% of females vs 79% of males reported PTH and females also demonstrated a longer duration of symptoms compared to males (median recovery time of 80 vs 34 days), 20 the authors concluded that the role of gender remains uncertain because other important potential risk factors, such as prior headache history, were not reported.…”

Section: Risk Factors For Concussion and Post‐traumatic Headachementioning

confidence: 92%

“…There is also likely a role for psychosocial and environmental factors in the pathophysiology of persistent PTH 7 . These include symptom expectation, adjustment disorder, poor coping mechanisms, post‐traumatic stress disorders, anxiety, depression, sleep disorders, and other psychosocial stressors 9,20 . Medication overuse headache (MOH) may also alter the pathophysiology of PPTH and complicate recovery 18 …”

Section: Pathophysiology Of Concussion and Post‐traumatic Headachementioning

confidence: 99%

“…A recent study investigating risk factors for prolonged PCS found that a personal or family history of mood disorders or migraine as well as a history of prior mTBI with delayed symptom onset were associated with symptoms persisting for >3 months post‐injury 24 . Conflicting data exist on the association between risk of PTH and prior mTBI, however, with another study finding no significant difference in the occurrence of PTH in relation to the number of prior concussions 20 . Interestingly, however, a 2019 trial found that the only risk factor for the development of PTH was a past history of primary headache 25 and that in 90% the PTH phenotyped to migraine.…”

Section: Risk Factors For Concussion and Post‐traumatic Headachementioning

confidence: 99%

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Pediatric Post‐Traumatic Headache and Implications for Return to Sport: A Narrative Review

2020

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Background.-Headache attributed to mild traumatic injury of the head (aka: mild traumatic brain injury, mTBI), frequently abbreviated to Post-Traumatic Headache (PTH), is one of the most common and disabling symptoms after a head injury. PTH often phenotypes to migraine. Evidence for treating PTH in the pediatric population is limited. Widely accepted guidelines do not exist to aid the clinician and there are currently no placebo-controlled trials for the pharmacologic management of PTH in this age group. Recommendations for when to return a child or adolescent to sport if they develop and/or are being treated for persistent PTH (PPTH) are lacking. The objective of this narrative review is to review the implications of returning an adolescent with PPTH to sport.Methods.-Pediatric neurologists with special qualification in headache collaborated on this narrative review. Literature was searched up until Oct 2019 for articles pertaining to PTH, concussion, mTBI, and the return of a pediatric athlete to sport after mTBI. Article inclusion was at the discretion of the authors. There was author consensus regarding all recommendations made.Conclusion.-The authors recommend that strict adherence to the guidelines that return to sport cannot occur until a child is symptom free at rest, off any medication, may be unreasonable in certain situations. Symptom stability is the proposed new concept for return to sport.Abbreviations: CDC Center for Disease Control, mTBI mild traumatic brain injury, PPTH persistent post-traumatic headache, PTH post-traumatic headache, RTP return to play

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“…While a complete discussion of their efficacy is beyond the scope of this review, amitriptyline has been shown to be most effective for post-concussive headaches. 48 …”

Section: Management: Medicationsmentioning

confidence: 99%

Pediatric Mild Traumatic Brain Injury in the Acute Setting

Corwin¹,

Grady²,

Joffe³

et al. 2017

Pediatr Emer Care

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Pediatric mild traumatic brain injuries, most of which are concussions, are an increasingly common reason for presentation to emergency departments. The diagnosis of concussion has increased dramatically over the past decade, necessitating the acute care provider to have up-to-date knowledge of the definition, pathophysiology, signs and symptoms, physical examination findings, and acute management of pediatric concussion. This article also addresses populations most vulnerable to prolonged recovery from pediatric concussion and referral recommendations.

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Demographics and Treatment of Adolescent Posttraumatic Headache in a Regional Concussion Clinic

Cited by 35 publications

References 44 publications

Rest and treatment/rehabilitation following sport-related concussion: a systematic review

Rest and treatment/rehabilitation following sport-related concussion: a systematic review

Pediatric Post‐Traumatic Headache and Implications for Return to Sport: A Narrative Review

Pediatric Mild Traumatic Brain Injury in the Acute Setting

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