title: Headache after pediatric traumatic brain injury: a cohort study.
abstract: OBJECTIVE
  To determine the prevalence of headache 3 and 12 months after pediatric traumatic brain injury (TBI).
  
  
  METHODS
  This is a prospective cohort study of children ages 5 to 17 years in which we analyzed the prevalence of headache 3 and 12 months after mild TBI (mTBI; n = 402) and moderate/severe TBI (n = 60) compared with controls with arm injury (AI; n = 122).
  
  
  RESULTS
  The prevalence of headache 3 months after injury was significantly higher after mTBI than after AI overall (43% vs 26%, relative risk [RR]: 1.7 [95% confidence interval (CI): 1.2-2.3]), in adolescents (13-17 years; 46% vs 25%, RR: 1.8 [95% CI: 1.1-3.1]), and in girls (59% vs 24%, RR: 2.4 [95% CI: 1.4-4.2]). The prevalence of headache at 3 months was also higher after moderate/severe TBI than AI in younger children (5-12 years; 60% vs 27%; RR: 2.0 [95% CI: 1.2-3.4]). Twelve months after injury, TBI was not associated with a significantly increased frequency of headache. However, girls with mTBI reported serious headache (≥ 5 of 10 pain scale rating) more often than controls (27% vs 10%, RR: 2.2 [95% CI: 0.9-5.6]).
  
  
  CONCLUSIONS
  Pediatric TBI is associated with headache. A substantial number of children suffer from headaches months after their head injury. The prevalence of headache during the year after injury is related to injury severity, time after injury, age, and gender. Girls and adolescents appear to be at highest risk of headache in the months after TBI.
authors.affiliation: Division of Pediatric Neurology, University of Washington, Seattle, Seattle, WA 98105, USA. heidi.blume@seattlechildrens.org
authors.forename: Heidi K
authors.initials: HK
authors.lastname: Blume
authors.forename: Monica S
authors.initials: MS
authors.lastname: Vavilala
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Jaffe
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Koepsell
authors.forename: Jin
authors.initials: J
authors.lastname: Wang
authors.forename: Nancy
authors.initials: N
authors.lastname: Temkin
authors.forename: Dennis
authors.initials: D
authors.lastname: Durbin
authors.forename: Andrea
authors.initials: A
authors.lastname: Dorsch
authors.forename: Frederick P
authors.initials: FP
authors.lastname: Rivara
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003625:Data Collection; D005260:Female; D006261:Headache / Q000209:etiology*; D006801:Humans; D008297:Male; D010147:Pain Measurement; D015995:Prevalence