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Persistent Headache and Cephalic Allodynia Attributed to Head Trauma in Children and Adolescents
Tal Eidlitz Markus1, Avraham Zeharia2, Yishai Haimi Cohen2
1Pediatric Headache Clinic, Day Hospitalization Department, Schneider Children's Medical Center of Israel, Petach Tikva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel eidlitz@post.tau.ac.il.
Insights
Children with traumatic brain injuries often experience allodynia, a heightened sensitivity to touch, more than those without injuries. This suggests potential central nervous system changes following head trauma in pediatric patients.
Area of Science:
- Pediatric Neurology
- Neurotraumatology
- Pain Medicine
Background:
- Traumatic brain injury (TBI) can lead to various neurological complications, including headaches.
- Understanding the specific clinical features of headaches post-TBI in children is crucial for diagnosis and management.
- Distinguishing between post-traumatic headaches and primary headache disorders in pediatric populations can be challenging.
Purpose of the Study:
- To investigate clinical features of headaches in children and adolescents following mild versus moderate to severe traumatic brain injury.
- To compare post-traumatic headaches with primary headaches in pediatric patients.
- To identify characteristics associated with different TBI severities and headache types.
Main Methods:
- Retrospective review of 74 pediatric patients diagnosed with mild (n=60) or moderate to severe (n=14) traumatic brain injury.
- Analysis of headache characteristics including migraine-like, tension-like, and unspecified types.
- Comparison of clinical features with 174 control patients without TBI.
Main Results:
- Migraine-like headache was present in 54% of TBI patients, tension-like in 31.1%, and unspecified in 14.9%.
- Allodynia was reported by 53.8% of TBI patients, a significantly higher proportion compared to controls.
- TBI patients showed a lower proportion of migraine-like headaches and a higher proportion of males and allodynia compared to controls.
Conclusions:
- The high prevalence of allodynia in pediatric TBI patients suggests a potential role for central sensitization.
- Clinical features of headaches post-TBI in children may differ from primary headache disorders.
- Further research is needed to elucidate the mechanisms and optimal treatment strategies for post-traumatic headaches in children.
Abstract:
The aim of the study was to investigate clinical features of headache associated with minor versus moderate to severe traumatic brain injury and of posttraumatic versus primary headache in children and adolescents. Study group included 74 patients after mild (n = 60) or moderate to severe (n = 14) traumatic brain injury identified by retrospective review of the computerized files of a tertiary pediatric headache clinic. Forty patients (54%) had migraine-like headache, 23 (31.1%) tension-like headache, and 11 (14.9%) nonspecified headache. Fourteen patients (53.8%) had allodynia. In comparison with 174 control patients, the study group had a significantly lower proportion of patients with migraine-like headache and a higher proportion of male patients and patients with allodynia. There was no statistically significant correlation of any of the clinical parameters with the type or severity of the posttraumatic headache or rate of allodynia. The high rate of allodynia in the study group may indicate a central sensitization in posttraumatic headache.
