Shah Ryan, Das Soumyaa, Gentile Kruse Caroline F, de Prado Blanca Marquez, Raj Nichelle, Evans Morgan, Panigrahi Pratishtha, Hershey Andrew D, Master Christina L, Szperka Christina L, Patterson Gentile Carlyn
Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.
Case Western Reserve University, Cleveland, Ohio.
Pediatr Neurol. 2025 Jun;167:96-102. doi: 10.1016/j.pediatrneurol.2025.03.013. Epub 2025 Mar 27.
Triptans are used to treat migraine attacks, but little to no evidence supports their use for youth with post-traumatic headache (PTH). This study evaluated patterns of use and benefit of triptans in the treatment of acute headache worsening in youth with PTH.
A single-center retrospective cohort study was conducted by reviewing charts for 332 patients aged eight to 17 years seen in a child neurology clinic for PTH within one year of concussion. Treatment responses and side effects were recorded. Demographic and headache characteristics associated with triptan use and treatment response were examined.
Eighty of 332 patients (24.1%) used a triptan. Of those, 34 (42.5%) had acute (less than three months) PTH and 46 (57.5%) had persistent (greater than or equal to three months) PTH. Median time from injury to triptan prescription was 123 days (interquartile range, 50, 242). Older patients, those with headache phenotype consistent with migraine, those who previously used a greater number of treatments for acute headache worsening, and those seen by the headache program were more likely to use triptans (χ > 7.00, P < 0.01). Sixty percent reported at least partial headache relief with their first triptan, whereas 25% reported side effects, all of which were minor.
These findings show triptans are more likely to be used for youth with PTH with phenotype consistent with migraine that are unrelieved by other treatments for acute headache worsening. Triptans may be an effective treatment for acute headache worsening in youth with PTH, although randomized controlled trials are needed.
曲坦类药物用于治疗偏头痛发作，但几乎没有证据支持其用于创伤后头痛（PTH）的青少年患者。本研究评估了曲坦类药物在治疗PTH青少年急性头痛加重方面的使用模式和疗效。
通过回顾332例8至17岁在儿童神经科诊所就诊的脑震荡后1年内患PTH患者的病历，进行了一项单中心回顾性队列研究。记录治疗反应和副作用。研究了与使用曲坦类药物及治疗反应相关的人口统计学和头痛特征。
332例患者中有80例（24.1%）使用了曲坦类药物。其中，34例（42.5%）患有急性（少于3个月）PTH，46例（57.5%）患有持续性（大于或等于3个月）PTH。从受伤到开具曲坦类药物处方的中位时间为123天（四分位间距，50，242）。年龄较大的患者、头痛表型与偏头痛一致的患者、之前因急性头痛加重使用过更多治疗方法的患者以及在头痛项目就诊的患者更有可能使用曲坦类药物（χ>7.00，P<0.01）。60%的患者报告首次使用曲坦类药物后头痛至少部分缓解，而25%的患者报告有副作用，均为轻微副作用。
这些发现表明，曲坦类药物更有可能用于PTH且表型与偏头痛一致、其他治疗急性头痛加重无效的青少年患者。曲坦类药物可能是治疗PTH青少年急性头痛加重的有效方法，尽管仍需要进行随机对照试验。
