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Post-Traumatic Headache in Children after Minor Head Trauma: Incidence, Phenotypes, and Risk Factors
Arianna Dondi1, Giovanni Battista Biserni2, Sara Scarpini2
1Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
Insights
Post-traumatic headache (PTH) affects 13% of children after minor head trauma (MHT). Headache upon arrival, especially with nausea or dizziness, increases PTH risk in children.
Area of Science:
- Pediatric Emergency Medicine
- Neurology
- Trauma Care
Background:
- Minor head trauma (MHT) is common in children, with post-traumatic headache (PTH) being a frequent complication.
- Effective management strategies for pediatric PTH remain a challenge.
Purpose of the Study:
- To determine the incidence, clinical features, and risk factors for PTH in children experiencing MHT.
- To identify children at higher risk for developing PTH.
Main Methods:
- A prospective study of 193 children (aged 3-14 years) presenting to a pediatric emergency department (PED) for MHT.
- Patients were followed for 6 months via phone calls and/or visits to assess PTH development and characteristics.
Main Results:
- PTH occurred in 13% of children (25/193).
- Prevalence was higher in school-aged children (≥6 years) versus preschool-aged children (21.6% vs. 4.9%).
- Headache upon arrival in the PED, with or without nausea and dizziness, was a significant predisposing factor for PTH.
Conclusions:
- PTH is a notable complication of MHT in children, with specific risk factors identified.
- Early identification of at-risk children can facilitate targeted follow-up, counseling, and treatment.
Abstract:
Minor head trauma (MHT) is very frequent in children and post-traumatic headache (PTH) is one of its most common complications; however, its management is still a challenge. We aimed to assess the incidence and clinical characteristics of, and risk factors for, PTH among children referred to our pediatric emergency department (PED) for MHT. A total of 193 patients aged 3-14 years evaluated for MTH were enrolled and followed up for 6 months through phone calls and/or visits. PTH occurred in 25/193 patients (13%). PTH prevalence was significantly higher in school-aged (≥6 years) than in pre-school-aged children (21.6% vs. 4.9%, respectively, p < 0.009). Females were found to be more affected. The median time of onset was 4.6 days after MHT; resolution occurred in a median of 7 weeks. In 83.3% of patients, PTH subsided in <3 months, while in 16.7% it persisted longer. A total of 25% of children exhibited the migraine and 75% the tension-type variant. Our analysis indicates the presence of headache upon arrival in PED, isolated or associated with nausea and dizziness, as a factor predisposing the patient to the development of PTH. Our findings could be useful to identify children at risk for PTH for specific follow-up, family counseling, and treatment.
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