title: Part I--Evaluation of pediatric post-traumatic headaches.
abstract: BACKGROUND
  Brain injury is one of the most common injuries in the pediatric age group, and post-traumatic headache is one of the most common symptoms following mild traumatic brain injury in children.
  
  
  METHODS
  This is an expert opinion-based two-part review on pediatric post-traumatic headaches. Part I will focus on an overview and approach to the evaluation of post-traumatic headache. Part II will focus on the medical management of post-traumatic headache. Relevant articles were reviewed, and an algorithm is proposed.
  
  
  RESULTS
  We review the epidemiology, classification, pathophysiology, and clinical approach to evaluating patients with post-traumatic headache. A comprehensive history and physical examination are fundamental to identifying the headache type(s). Identifying the precise headache phenotype is important to help guide treatment. Most of the post-traumatic headaches are migraine or tension type, but occipital neuralgia, cervicogenic headache, and medication overuse headache also occur. Postconcussive signs often resolve within 1 month, and individuals whose signs persist longer may benefit from an interprofessional approach.
  
  
  CONCLUSIONS
  Rigorous evaluation and diagnosis are vital to treating post-traumatic headaches effectively. A multifaceted approach is needed to address all the possible contributing factors to the headaches and any comorbid conditions that may delay recovery or alter treatment choices.
authors.affiliation: Division of Pediatric Neurology, Departments of Pediatrics and Neurology/Neurosurgery, Montreal Children's Hospital / McGill University Health Centre (MUHC), Montreal, Quebec, Canada.
authors.forename: Elana
authors.initials: E
authors.lastname: Pinchefsky
authors.affiliation: Department of Pediatric Emergency Medicine, Montreal Children's Hospital Trauma Centre, McGill University Health Centre, Montreal, Quebec, Canada.
authors.forename: Alexander Sasha
authors.initials: AS
authors.lastname: Dubrovsky
authors.affiliation: Trauma Programs, Mild Traumatic Brain Injury Program, Concussion Clinic, Montreal, Quebec, Canada; Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), Department of Pediatrics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
authors.forename: Debbie
authors.initials: D
authors.lastname: Friedman
authors.affiliation: Department of Pediatrics, Departments of Pediatrics and Neurology/Neurosurgery, Montreal Children's Hospital Trauma Centre, McGill University Health Centre, Montreal, Quebec, Canada. Electronic address: michael.shevell@muhc.mcgill.ca.
authors.forename: Michael
authors.initials: M
authors.lastname: Shevell
mesh_terms: D006801:Humans; D010372:Pediatrics; D051298:Post-Traumatic Headache / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology
keywords: brain concussion; closed head injuries; mild traumatic brain injury; pediatrics; post-traumatic headache; secondary headache disorders; symptom assessment