Department of Pediatrics, Maulana Azad Medical College (University of Delhi) and associated Lok Nayak Hospital, Delhi 110002, India.
Department of Neurosurgery, Lok Nayak Hospital, Delhi, 110002, India.
Childs Nerv Syst. 2021 Jun;37(6):1943-1948. doi: 10.1007/s00381-020-05032-4. Epub 2021 Jan 6.
To study the clinical profile and factors associated with post-traumatic headache (PTH) in children with mild traumatic brain injury (mTBI) attending an urban public hospital.
We enrolled 130 consecutive children aged 6-12 years with mTBI (as per the International Classification of Headache Disorders-III criteria), and followed them up for 7 days. Those who developed PTH were further followed up monthly for 3 months.
Thirty (23.1%) children developed PTH; 25 (19.2%) children had acute PTH (duration 7 days to 3 months) and the remaining 5 (3.8%) developed persistent PTH (> 3 months). Majority (50%) had bilateral headache and squeezing quality (50%). Forty percent of those with PTH met the criteria for migraine. Obesity (P = 0.84), female gender (P = 0.26), family history of headache (P = 0.93), and prior history of concussion (P = 0.70) were not associated with risk of PTH. Children who developed PTH had higher rate of nausea (RR (95% CI) = 2.42 (1.06, 5.5); P = 0.03) and vomiting (RR (95% CI) = 3.76 (1.64, 8.5); P = 0.001) after mTBI. Headache resolved within 1 month in 63.3% of children.
PTH was found to be common after mTBI in children. Protocolized follow-up and directed history taking for PTH in all children with mTBI, who are frequently discharge from the emergency department after first aid, will lead to appropriate diagnosis and management of this problem.
研究在城市公立医院就诊的轻度创伤性脑损伤（mTBI）患儿中，与创伤后头痛（PTH）相关的临床特征和因素。
我们纳入了 130 例年龄在 6-12 岁的连续 mTBI 患儿（根据国际头痛疾病分类-III 标准），并对其进行了 7 天的随访。那些出现 PTH 的患儿进一步每月随访 3 个月。
30 例（23.1%）患儿出现 PTH；25 例（19.2%）患儿出现急性 PTH（持续时间 7 天至 3 个月），其余 5 例（3.8%）患儿出现持续性 PTH（>3 个月）。大多数（50%）患儿的头痛具有双侧性和挤压感（50%）。40%的 PTH 患儿符合偏头痛标准。肥胖（P=0.84）、女性（P=0.26）、头痛家族史（P=0.93）和既往脑震荡史（P=0.70）与 PTH 风险无关。发生 PTH 的患儿在 mTBI 后恶心（RR（95%CI）=2.42（1.06，5.5）；P=0.03）和呕吐（RR（95%CI）=3.76（1.64，8.5）；P=0.001）的发生率更高。63.3%的患儿头痛在 1 个月内缓解。
在 mTBI 后，儿童中常出现 PTH。对所有经常在急救后从急诊室出院的 mTBI 患儿进行 PTH 的常规随访和定向病史采集，将有助于对该问题进行适当的诊断和管理。
