Objective

To study the clinical profile and factors associated with post-traumatic headache (PTH) in children with mild traumatic brain injury (mTBI) attending an urban public hospital.

Methods

We enrolled 130 consecutive children aged 6–12 years with mTBI (as per the International Classification of Headache Disorders-III criteria), and followed them up for 7 days. Those who developed PTH were further followed up monthly for 3 months.

Results

Thirty (23.1%) children developed PTH; 25 (19.2%) children had acute PTH (duration 7 days to 3 months) and the remaining 5 (3.8%) developed persistent PTH (> 3 months). Majority (50%) had bilateral headache and squeezing quality (50%). Forty percent of those with PTH met the criteria for migraine. Obesity (P = 0.84), female gender (P = 0.26), family history of headache (P = 0.93), and prior history of concussion (P = 0.70) were not associated with risk of PTH. Children who developed PTH had higher rate of nausea (RR (95% CI) = 2.42 (1.06, 5.5); P = 0.03) and vomiting (RR (95% CI) = 3.76 (1.64, 8.5); P = 0.001) after mTBI. Headache resolved within 1 month in 63.3% of children.

Conclusion

PTH was found to be common after mTBI in children. Protocolized follow-up and directed history taking for PTH in all children with mTBI, who are frequently discharge from the emergency department after first aid, will lead to appropriate diagnosis and management of this problem.

中文翻译：

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轻度创伤性脑损伤儿童创伤后头痛的临床特征和短期病程：一项前瞻性队列研究

客观的

研究城市公立医院轻度创伤性脑损伤 (mTBI) 儿童发生创伤后头痛 (PTH) 的临床特征和相关因素。

方法

我们连续招募了 130 名 6-12 岁患有 mTBI 的儿童（根据国际头痛疾病分类 III 标准），并对他们进行了 7 天的随访。那些发展为 PTH 的人每月进一步随访 3 个月。

结果

30 (23.1%) 名儿童患了 PTH；25 名 (19.2%) 儿童患有急性 PTH（持续时间 7 天至 3 个月），其余 5 名 (3.8%) 儿童患有持续性 PTH（> 3 个月）。大多数 (50%) 有双侧头痛和挤压质量 (50%)。40% 的 PTH 患者符合偏头痛的标准。肥胖 ( P =  0.84)、女性 ( P =  0.26)、头痛家族史 ( P =  0.93) 和脑震荡史 ( P =  0.70) 与 PTH 风险无关。发生 PTH 的儿童恶心 (RR (95% CI) = 2.42 (1.06, 5.5); P =  0.03) 和呕吐 (RR (95% CI) = 3.76 (1.64, 8.5); P =  0.001)脑外伤。63.3% 的儿童头痛在 1 个月内得到解决。

结论

在儿童 mTBI 后发现 PTH 很常见。所有 mTBI 儿童经常在急救后从急诊室出院，对 PTH 进行规程化的随访和有针对性的病史采集，将导致对该问题的适当诊断和管理。