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Study: Teens, Girls More Likely to Suffer Headaches After Head Trauma

A substantial number of children suffer headaches months after sustaining a traumatic brain injury (TBI), with girls and teenagers even more prone, according to a study published online Monday in Pediatrics.

With more than 500,000 children suffering TBIs each year, according to the study's authors, teachers and coaches alike must keep in mind that a TBI can be a long-term, multi-month injury, despite no visible damage.

The study examined children ages 5 to 17 who were either hospitalized in nine institutions in King County, Washington state, or a hospital in Philadelphia. The researchers compared the prevalence of headaches in children who suffered mild TBIs or moderate to severe TBIs with a control group of children with arm injuries and no head injuries. (A concussion is an example of a mild TBI.) The control group, with no head injuries, would suggest the typical rate of headaches in youths.

Three months after suffering a mild TBI, 43 percent of children reported having headaches. Somewhat surprisingly, only 37 percent of children who suffered moderate to severe TBIs reported headaches, compared with 26 percent of the children with arm injuries in the control group.

While the authors did not suggest why headaches would be more prevalent in the mild TBI group than the moderate-to-severe group, they discovered that headaches were more than twice as common in younger children (ages 5 to 12) who suffered moderate or severe TBIs.

Three months after a moderate or severe TBI, 60 percent of children ages 5-12 reported headaches, compared with only 27 percent of the children with arm injuries. Nearly 50 percent of adolescents (ages 13 to 17) reported headaches three months after a mild TBI, and nearly 60 percent of girls did so, too.

Notably, one year after the injuries, the researchers did not discover any significant difference in terms of headaches for the control group and the groups with brain injuries (this includes both the mild TBI and moderate-to-severe TBI groups).

"Little research has focused on chronic headache post-TBI in children," said lead author Dr. Heidi Blume, assistant professor of neurology at the University of Washington, 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."

The researchers observed that the prevalence of headaches in the year after an injury was mainly tied to the severity of the injury (whether it was a mild, moderate, or severe TBI, with mild injuries having the highest rate of headaches), the time after the injury, gender, and age.

"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."

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