Post-Traumatic Headache in Children and Adolescents: a Narrative Review with a Focus on Management
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(2020) 20:53
HEADACHE (R.B. HALKER, SECTION EDITOR)
Post-Traumatic Headache in Children and Adolescents: a Narrative Review with a Focus on Management Danny Adel Monsour 1 & Christine Lay 1 & Tasjeel Ansari 1 & Ana Marissa Lagman-Bartolome 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Although common, post-traumatic headache (PTH) in the pediatric population is a niche group with a paucity of published evidence on the diagnosis, most appropriate acute and preventative management, and prognosis. This article aims to review pediatric PTH, its epidemiology and pathophysiology with a focus on management and future directions. Recent Findings Using MEDLINE, EMBASE, 52 articles on PTH in children and adolescents from 2016 to 2020 were identified. Over the last 4 years, our understanding of traumatic brain injury pathophysiology has grown, expanding the potential for more therapeutic targets. Despite this achievement, and recently published consensus guidelines, the review demonstrated a lack of published controlled trials to help guide management of pediatric PTH. Summary The last 4 years have provided new insights into the potential pathophysiological mechanisms through laboratory research and advanced MR imaging; however, there continues to be a translational gap to clinical practice. Keywords Post-traumatic headache . Concussion . Adolescent . Children . Pediatric . Headache
Introduction The International Classification of Headache Disorders (ICHD) 3rd edition categorizes post-traumatic headache (PTH) for both pediatric and adult populations as a secondary headache disorder under the category of headache attributed to trauma or injury to the head and/or neck [1•]. The headache can be either new or preexisting wherein a primary headache disorder is made significantly worse in close relation to the inciting event. Moreover, the headache can be acute when the headache lasts no more than 3 months or persistent if beyond 3 months [1•]. The headache This article is part of Topical Collection on Headache * Danny Adel Monsour [email protected] Christine Lay [email protected] Tasjeel Ansari [email protected] Ana Marissa Lagman-Bartolome [email protected] 1
Centre for Headache, Women’s College Hospital, University of Toronto, 76 Grenville Street, 3rd Floor, Toronto, Ontario M5S 1B2, Canada
from head trauma should occur within the first 7 days from injury, from discontinuation of headache “masking” medications or from the time consciousness is regained. The challenge with treating PTH in the pediatric population is the scarcity of data on the precise strategies to help prevent and acutely manage headaches post-head injury. Much of the management for PTH overlaps with the management of primary headaches with migraine or tension-type headache as the more common phenotypes of PTH. A retrospective study from Israel found that in a pediatric cohort of 74 subjects with mild to moderate traumatic brain injury (TBI), 54% had migraine-l
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