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Vomiting after mild head injury is related to migraine
M M Jan1, P R Camfield, K Gordon
1Division of Child Neurology, Department of Pediatrics, IWK-Grace Health Centre and Dalhousie University Medical School, Halifax, Nova Scotia, Canada.
Insights
Vomiting after mild head injury in children is strongly linked to a history of motion sickness or migraine headaches. These factors, along with a family history of migraine, significantly predict vomiting in pediatric head injury cases.
Area of Science:
- Pediatric Emergency Medicine
- Neurology
- Clinical Pediatrics
Background:
- Vomiting is a common symptom following mild head injury in children.
- The underlying causes and predictive factors for vomiting require further investigation.
Purpose of the Study:
- To investigate the association between vomiting and migraine in children with mild head injuries.
- To identify key predictors of post-head injury vomiting in pediatric patients.
Main Methods:
- Chart review of children admitted to an emergency department observation unit after mild head injury.
- Structured telephone interviews with parents and/or children using a standardized questionnaire.
Main Results:
- Of 44 children studied, 66% experienced vomiting post-head injury.
- A history of recurrent headaches, particularly migrainous headaches, significantly increased the likelihood of vomiting.
- History of motion sickness and a family history of migraine were also strong predictors of vomiting.
Conclusions:
- Motion sickness, personal history of migraine, and family history of migraine are highly predictive of vomiting after mild head injury in children.
- The presence of multiple predictive factors indicates a 100% likelihood of vomiting.
Objective:
To determine whether vomiting after mild head injury in children is related to migraine and to identify predictors of vomiting after head injury.
Methods:
A series of consecutive children admitted to the observation unit of an emergency department after mild head injury was identified by chart review. A telephone interview with the parents or child or both was then conducted by using a structured questionnaire.
Results:
Of 47 eligible children with acute head injury, 44 (94%) were contacted. The mean age at head injury was 7.4 years. Twenty-nine children (66%) vomited after the head injury. The likelihood of vomiting was increased if the child had a history of recurrent headache (p = 0.05). If the headaches were migrainous, the likelihood of vomiting increased further (p <0.002). All 15 children with a history of motion sickness vomited after the head injury. Family history of migraine, particularly maternal (n = 21), also predicted recurrent vomiting (p <0.001). If more than one of these predictive variables was present, the likelihood of vomiting was 100%.
Conclusions:
History of motion sickness, migraine headaches, and family history of migraine are highly predictive of vomiting after a mild head injury.