Longitudinal trajectories of posttraumatic headache after pediatric mild traumatic brain injury

Area of Science:

• Neurology
• Pediatric Medicine
• Trauma Research

Background:

• Posttraumatic headache (PTH) is a common sequela following mild traumatic brain injury (mTBI).
• Understanding the trajectory and characteristics of PTH in children is crucial for effective management.
• Previous studies have varied in their assessment of PTH following pediatric head injuries.

Purpose of the Study:

• To examine the trajectory, classification, and features of posttraumatic headache (PTH) after pediatric mild traumatic brain injury (mTBI).
• To compare PTH incidence and characteristics between children with mTBI and those with mild orthopedic injuries.
• To identify factors influencing PTH development and persistence in a pediatric cohort.

Main Methods:

• Prospective, longitudinal cohort study involving 213 children (ages 8-16.99 years) recruited from pediatric emergency departments within 24 hours of injury.
• Standardized questionnaires administered at 10 days, 3 months, and 6 months postinjury to classify premorbid and posttraumatic headache.
• Multilevel mixed effects models used to analyze PTH rate, severity, frequency, and duration, controlling for covariates.

Main Results:

• PTH risk was substantially higher after mTBI compared to mild orthopedic injury at 10 days (OR=197.41) and 3 months (OR=3.50) postinjury.
• Posttraumatic headache was more frequent following mTBI (β=0.80).
• The increased risk was particularly notable in children without a history of premorbid headache.

Conclusions:

• Posttraumatic headache risk is elevated for approximately three months following pediatric mild traumatic brain injury compared to mild orthopedic injury.
• The study did not identify a distinct phenotypic presentation for posttraumatic headache in this pediatric cohort.
• Findings underscore the importance of monitoring for and managing PTH in children after mTBI.