The Child Health After Injury Study, recently published in Pediatrics, the official journal of the American Academy of Pediatrics, found that the frequency of headache after Traumatic Brain Injury (TBI) is related to patient gender, age and injury severity. Specifically, headaches occurring after mild TBI (mTBI) are most common among girls and teenagers. The study also supports the notion that there are differences in symptoms of and recovery from TBI between boys and girls.
The study sought to evaluate the outcome and health after pediatric TBI compared with a control population of children with arm injury (AI). The study’s goal was to use data from the study to determine the prevalence of headache at three to 12 months after mild, moderate and severe TBI compared with the control population with AI to determine if TBI is associated with headache three to 12 months after injury. The study also examined age and gender related differences in headache frequency after TBI because TBI has age and gender dependent features.
The researchers found that the risk of migraine is similar in young boys and girls until puberty, when migraine prevalence begins to increase with age in girls, but not boys, reaching adult levels in late adolescence when migraine is much more common in girls than boys.
Three months after injury, girls, not boys, had a significantly higher risk of any headache after mTBI compared with controls. In girls, the prevalence of serious headache three months after mTBI increased with age (7% aged 5 to 7 years, 20% aged 8 to 10 years, 29% aged 11 to 13 years, and 45% aged 14 to 17 years).
Twelve months after injury, girls with mTBI appeared to have a higher rate of headache compared with controls, however there was no statistical significance in the sample. Girls with mTBI also appeared to have a higher prevalence of serious headache than controls 12 months after injury. Also, adolescent girls reported more headaches 12 months after mTBI than controls for all headache questions on the teenager survey.
These findings correspond with other recent studies that have found that postconcussive symptoms are more common after mTBI than extracranial injury in children and that women have a higher risk of headache after mTBI than men.
In conclusion, the association between TBI and headache is most remarkable in girls and adolescents after mTBI and in younger children after moderate/severe TBI. There may also be an association between both mild and moderate/severe TBI and headache one year after injury for adolescent girls.