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[Headache as the consequence of brain concussion and contusion in closed head injuries in children]
1Klinika Neurologii Rozwojowej Katedry Neurologii Akademii Medycznej w Gdańsku.
Insights
Post-traumatic headache is common in children after concussion or contusion, with most experiencing acute headaches, but a significant portion developing chronic symptoms. Age and unconsciousness duration are key risk factors for persistent headaches.
Area of Science:
- Pediatric Neurology
- Traumatology
Background:
- Headache is the primary complaint following pediatric head injuries like concussion and contusion.
- Limited research exists on the incidence, characteristics, and duration of post-traumatic headaches (PTH) in children.
Purpose of the Study:
- To investigate the occurrence, nature, and persistence of headaches in children following mild traumatic brain injury (TBI).
- To identify risk factors associated with the development of PTH in pediatric patients.
Main Methods:
- A cohort of 100 children (aged 3-14) with brain concussion or contusion, excluding those with pre-existing conditions, were studied.
- Participants were assessed for headaches within one week, and at 3, 6, and 12 months post-injury.
- Electroencephalography (EEG) was performed at 3 months and repeated as needed to evaluate persistent headaches or abnormal findings.
Main Results:
- 83% of children experienced headaches post-injury; 56% had acute PTH, while 27% developed chronic PTH, predominantly tension-type.
- 21% of children had headaches that persisted throughout the one-year observation period.
- Child's age at injury and duration of unconsciousness were significant risk factors for PTH.
Conclusions:
- Post-traumatic headache is a frequent consequence of pediatric mild TBI, with a notable percentage experiencing chronic symptoms.
- EEG remains a valuable tool for assessing post-traumatic neurological consequences.
- Early identification of risk factors like age and unconsciousness duration is crucial for managing pediatric PTH.
Abstract:
The most frequent type of head injury in children is closed head trauma with brain concussion or contusion, and headache is the dominant complaint of early and late postinjury period. Because of scant number of studies on the problem of occurrence, characteristics and persistence of posttraumatic headache this study was undertaken in a group of 100 children (29 girls and 71 boys), aged 3-14 years old, 90 after brain concussion and 10 after contusion. Children with a history of injuries, central nervous system infections, with headaches before injury and chronic diseases were excluded. In 9 cases linear skull fracture was present after injury. The material was examined within one week after trauma, and then after 3, 6, and 12 months. After 3 months EEG was performed and repeated after 6 and 12 months in children with persistent headache or those without headache but with abnormal EEG results in the first examination. According to the additional diagnostic examinations, I excluded other causes of headache, besides head injury. In my observation 83% of children had headache after brain concussion and contusion. The majority--56%--had acute posttraumatic headache, but 27% of children complained of chronic headache, mainly tension type headache. Only 3% had migraine. In 21% of all group of 100 children, I noticed the headache persisting during the whole year of my observation. The important risk factor for the occurrence of posttraumatic headache were the age of child at the moment injury and the period of unconsciousness. The electroencephalographic recording still remains the important additional examination of posttraumatic consequences.