Headache after pediatric traumatic brain injury: a cohort study.

TitleHeadache after pediatric traumatic brain injury: a cohort study.
Publication TypeJournal Article
Year of Publication2012
AuthorsBlume HK, Vavilala MS, Jaffe KM, Koepsell TD, Wang J, Temkin N, Durbin D, Dorsch A, Rivara FP
JournalPediatrics
Volume129
Issue1
Paginatione31-9
Date Published2012 Jan
ISSN1098-4275
KeywordsAdolescent, Brain Injuries, Child, Child, Preschool, Cohort Studies, Data Collection, Female, Headache, Humans, Male, Pain Measurement, Prevalence
Abstract

OBJECTIVE: To determine the prevalence of headache 3 and 12 months after pediatric traumatic brain injury (TBI).

METHODS: This is a prospective cohort study of children ages 5 to 17 years in which we analyzed the prevalence of headache 3 and 12 months after mild TBI (mTBI; n = 402) and moderate/severe TBI (n = 60) compared with controls with arm injury (AI; n = 122).

RESULTS: The prevalence of headache 3 months after injury was significantly higher after mTBI than after AI overall (43% vs 26%, relative risk [RR]: 1.7 [95% confidence interval (CI): 1.2-2.3]), in adolescents (13-17 years; 46% vs 25%, RR: 1.8 [95% CI: 1.1-3.1]), and in girls (59% vs 24%, RR: 2.4 [95% CI: 1.4-4.2]). The prevalence of headache at 3 months was also higher after moderate/severe TBI than AI in younger children (5-12 years; 60% vs 27%; RR: 2.0 [95% CI: 1.2-3.4]). Twelve months after injury, TBI was not associated with a significantly increased frequency of headache. However, girls with mTBI reported serious headache (≥ 5 of 10 pain scale rating) more often than controls (27% vs 10%, RR: 2.2 [95% CI: 0.9-5.6]).

CONCLUSIONS: Pediatric TBI is associated with headache. A substantial number of children suffer from headaches months after their head injury. The prevalence of headache during the year after injury is related to injury severity, time after injury, age, and gender. Girls and adolescents appear to be at highest risk of headache in the months after TBI.

DOI10.1542/peds.2011-1742
Alternate JournalPediatrics
PubMed ID22144708