• Geoffrey L Heyer and Syed A Idris.
• Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio; Department of Neurology, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio. Electronic address: geoffrey.heyer@nationwidechildrens.org.
• Pediatr. Neurol. 2014 May 1; 50 (5): 464-8.

BackgroundThe causes of persistent headache following concussion are poorly understood. The objective of this study is to explore analgesic overuse as a potential cause of chronic post-traumatic headache among adolescents referred to a headache clinic following concussion.MethodsA retrospective chart review was conducted of all adolescent concussion patients referred to our pediatric headache clinic over the 16-month period between August 1, 2011, and November 30, 2012. Those patients with chronic post-traumatic headaches of 3-12 months' duration who also met International Headache Society criteria for probable medication-overuse headache were identified. Demographic data, concussion symptoms, and headache features were characterized from the initial evaluation and from follow-up visits.ResultsOf 104 adolescent concussion patients referred during the study period, 77 had chronic post-traumatic headache of 3-12 months' duration. Fifty-four of 77 (70.1%) met criteria for probable medication-overuse headache. Only simple analgesics were overused. Thirty-seven patients (68.5%) had resolution of headaches or improvements to preconcussion headache patterns after discontinuing analgesics; seven (13%) had no change in headaches or worsening of headaches after discontinuing analgesics and 10 (18.5%) did not discontinue analgesics or were lost to follow-up.ConclusionExcessive use of analgesics postconcussion may contribute to chronic post-traumatic headaches in some adolescents. Management of patients with chronic post-traumatic headache should include analgesic detoxification when medication overuse is suspected.Copyright © 2014 Elsevier Inc. All rights reserved.

20 keywords...

hide…