Headaches after Traumatic Brain Injury Highest in Adolescents and Girls


New study may shed light on whether there are similarities in the cause of migraine and post-traumatic headache, and how this may impact treatment.

Adolescents and girls in particular are at an increased risk of developing headaches after suffering a traumatic brain injury (TBI), according to new research published in Pediatrics.

In the study, Heidi Blume, MD, MPH, and principal investigator Fred Rivara, MD, MPH, of Seattle Children’s Research Institute analyzed the prevalence of headaches 3 and 12 months after mild, moderate or severe TBI in children ages 5 to 17.

They found that headache can be a significant problem for children aged 5 to 12 years following TBI. Three months after a mild TBI, 43% of children reported headaches, compared to 37% of children who had a moderate to severe TBI, and 26% of children in the control group. The risk was determined to be higher in adolescents aged 13 to 17 and in girls.

It is estimated that more than half a million children in the United States sustain a TBI every year. Although it had been established that adults who suffer TBI often report headaches afterward, little is known about how often children suffer headaches after similar injuries.

Drs. Rivera and Blume’s research confirmed that the response to and recovery from TBI is different for children, adolescents and adults, and that males and females are likely to have different symptoms and recovery. The risk of headache was higher in adolescents and in girls, mirroring a pattern seen in other headache disorders such as migraine. Because of the high number of children suffering TBI every year, the study findings indicate that many children and adolescents suffer from TBI-associated headaches each year.

“Little research has focused on chronic headache post-TBI in children,” said Dr. Blume in a statement. “Our findings indicate that many children and adolescents suffer from TBI-associated headaches yearly. In addition, the prevalence of headache following mild TBI appears to follow a pattern we see in primary headache disorders such as a migraine. With future research, we can begin to examine whether there are similarities in the cause of migraine and post-traumatic headache, and if migraine therapies will work for post-traumatic headaches.”

Researchers were not able to detect significant differences in the percentage of children with headache after TBI one year after injury compared to children in the control group, who had suffered arm fractures. The study concluded that adolescents and girls appear to be at the highest risk for headache after mild TBI, and that the course of recovery from TBI is likely affected by age at injury, injury severity and gender.

“What parents need to know is that some children with TBI may have headaches for several weeks or months after TBI, but that most recover with time,” said Dr. Blume. “And significantly, girls and teenagers appear to be at particular risk for headaches after mild TBI. Parents should be aware of what to expect after mild TBI, which may come from a sports-related injury.”

If parents suspect that a child has suffered a concussion, it is critical to consult a medical care provider before allowing them to resume vigorous physical activity or play sports. If a child experiences repeated vomiting or severe new headache, is confused, off balance, or has new weakness, numbness or trouble speaking following a head injury, emergency care should be sought.

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