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Clinical profile and short-term course of post-traumatic headache in children with mild traumatic brain injury: a prospective cohort study

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Abstract

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.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

TBI:

Traumatic brain injury

mTBI:

Mild traumatic brain injury

PTH:

Post-traumatic headache

ICHD-3:

International Classification of Headache Disorders-3

HIT-6:

Headache Impact Test

PedMIDAS:

Pediatrics Migraine Disability Assessment Scale

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Authors and Affiliations

  1. Department of Pediatrics, Maulana Azad Medical College (University of Delhi) and associated Lok Nayak Hospital, Delhi 110002, India

    Purushottam Singh, Devendra Mishra & Monica Juneja

  2. Department of Neurosurgery, Lok Nayak Hospital, Delhi, 110002, India

    Purushottam Singh, Devendra Mishra, P. N. Pandey & Monica Juneja

Authors
  1. Purushottam Singh
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  2. Devendra Mishra
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  3. P. N. Pandey
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  4. Monica Juneja
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Corresponding author

Correspondence to Devendra Mishra.

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Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Ethics clearance

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Institutional Ethics Committee of Maulana Azad Medical College, F No. 17/IEC/MAMC/2018/15, Dated: 26/10/2018.

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Informed consent was obtained from all individual participants included in the study.

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Singh, P., Mishra, D., Pandey, P.N. et al. Clinical profile and short-term course of post-traumatic headache in children with mild traumatic brain injury: a prospective cohort study. Childs Nerv Syst 37, 1943–1948 (2021). https://doi.org/10.1007/s00381-020-05032-4

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  • DOI: https://doi.org/10.1007/s00381-020-05032-4

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