Relationship between postconcussion headache and neuropsychological test performance in high school athletes.
BACKGROUND
The relevance of headache to outcome after sports-related concussion is poorly understood.


OBJECTIVE
High school athletes reporting headache approximately 1 week after injury will have significantly more other concussion symptoms and will perform more poorly on neuropsychological tests than athletes not experiencing headache.


METHODS
Prospective cohort study.


METHODS
Study participants included 109 high school athletes who had sustained concussion and who were divided into two groups: those reporting headache 7 days after injury and those reporting no headaches. The two groups were compared regarding on-field markers of concussion severity at the time of injury and symptoms and neurocognitive test results collected via ImPACT, a computerized neuropsychological test battery and postconcussion symptom scale, at a mean of 6.8 days after injury.


RESULTS
Athletes reporting posttraumatic headache demonstrated significantly worse performance on reaction time and memory ImPACT neurocognitive composite scores. These athletes also reported significantly more symptoms other than headache and were more likely to have demonstrated on-field anterograde amnesia.


CONCLUSIONS
Findings suggest that any degree of postconcussion headache in high school athletes 7 days after injury is likely associated with an incomplete recovery after concussion.
Collins
Michael W
MW
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15203, USA.
Field
Melvin
M
Lovell
Mark R
MR
Iverson
Grant
G
Johnston
Karen M
KM
Maroon
Joseph
J
Fu
Freddie H
FH
D000293:Adolescent; D000648:Amnesia, Retrograde / Q000209:etiology / Q000503:physiopathology; D001265:Athletic Injuries / Q000150:complications / Q000503:physiopathology; D001924:Brain Concussion / Q000150:complications* / Q000503:physiopathology; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000175:diagnosis* / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D006261:Headache / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis* / Q000503:physiopathology; D009483:Neuropsychological Tests; D016017:Odds Ratio; D011446:Prospective Studies; D011930:Reaction Time / Q000502:physiology; D013178:Sports Medicine / Q000379:methods; D013647:Task Performance and Analysis; D013997:Time Factors