Treatments Often Fail Kids with Traumatic Headache
The number of kids diagnosed with concussions is on the rise, yet questions still linger about which treatments are effective for pediatric patients with brain injuries. Like adults with brain injuries, children with TBIs often suffer from posttrauamtic headache but few studies have examined how these symptoms may affect children differently.
Researchers from the University of Calgary in Canada recently studied a cohort of children with brain injuries to evaluate the characteristics and treatment of posttraumatic headache in kids. The study included 670 children with head injuries and 120 children with injuries other than TBI.
Within the first two weeks after a concussion, 11% of TBI kids said they suffered from headache. Although this number dropped to 7.8% three months later, the majority of kids with posttraumatic headache were still suffering from head pain well after sustaining a brain injury. This echoes the results of another recent study showing that adults can still suffer from posttraumatic headache for up to a year after the injury.
Of the children who had posttraumatic headache, 56% had a history of headache, 18% had migraine prior to the injury, and 82% had a family history of headache. The most common headache was migraine followed by tension-type, cervicogenic, and occipital neuralgia.
Medications typically prescribed to children included amitriptyline, flunarizine, topiramate, and melatonin. While the overall treatment response rate was high (64%), a number of children did not respond to medication. This suggests the need for additional research on effective treatment of headache in children with TBI.
The researchers recommended that kids with persistent posttraumatic headache be referred to a specialist, especially in cases that aren't typical of one of the primary headache disorders.
Kuczynski A, et al. Characteristics of post-traumatic headaches in children following mild traumatic brain injury and their response to treatment: a prospective cohort. Developmental Medicine and Child Neurology. 2013 Apr 5. doi: 10.1111/dmcn.12152. [Epub ahead of print]