Demographics and treatment of adolescent posttraumatic headache in a regional concussion clinic.
OBJECTIVE
Mild traumatic brain injury affects over one million pediatric patients annually. Minimal data and no guidelines exist regarding treatment of posttraumatic headache (PTH). The current study investigated treatment and outcomes in patients with posttraumatic headache.


METHODS
Medical records of all patients (age 13-18 years of age) seen at a regional concussion program from 2006 to 2011 were reviewed. Statistical analysis using SAS 9.2 was conducted to determine the effectiveness of treatment as well as the association of gender, concussion history, and football participation on the duration of posttraumatic headache.


RESULTS
Four hundred subjects met the inclusion criteria. Females were more likely to report posttraumatic headache than males (90% vs. 79%, P = 0.004), more likely to be prescribed amitriptyline (24% vs. 13%, P = 0.004), and had a significantly longer recovery time (median, 80 days versus 34 days, P < 0.001). Seventeen percent of subjects were prescribed amitriptyline for treatment of posttraumatic headache, of which 82% reported a beneficial effect. There was no difference in the percentage of posttraumatic headache or recovery time in football players versus other male athletes from other sport mechanisms.


CONCLUSIONS
Females are more likely to report posttraumatic headache than males and also take longer to recover. Amitriptyline appears to be well-tolerated and an effective treatment strategy for patients with posttraumatic headache. Among pediatric patients evaluated in a concussion clinic, there is no difference in the proportion of football players reporting headaches compared with male players of other sports.
Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania. Electronic address: hbramley@hmc.psu.edu.
Harry
H
Bramley
Adolescent pediatrician, Tan & Garcia Pediatrics, Harrisburg, Pennsylvania.
Steven
S
Heverley
Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.
Mechelle M
MM
Lewis
Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.
Lan
L
Kong
Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.
Rowena
R
Rivera
Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.
Matthew
M
Silvis
D000293:Adolescent; D000639:Amitriptyline / Q000627:therapeutic use*; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D001924:Brain Concussion / Q000150:complications*; D003710:Demography / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D010414:Pennsylvania / Q000453:epidemiology; D051298:Post-Traumatic Headache / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome
D018712:Analgesics, Non-Narcotic; D000639:Amitriptyline
amitriptyline; concussion; headache; mild traumatic brain injury; treatment