title: Post-traumatic headaches correlate with migraine symptoms in youth with concussion.
abstract: OBJECTIVE
  The term "post-traumatic migraine" (PTM) has been used to describe post-traumatic headaches (PTHs) that have associated migraine features, but studies of this relationship are lacking. The objective of the present study was to determine whether PTH correlates strongly with migraine symptoms among youth with concussion.
  
  
  METHODS
  Twenty-three symptoms were analyzed from a retrospective cohort of 1953 pediatric patients with concussion. A principal component analysis (PCA) with oblique Promax rotation was conducted to explore underlying symptom relationships in the full cohort and in subcohorts stratified by the presence (n = 414) or absence (n = 1526) of premorbid headache.
  
  
  RESULTS
  The mean patient age was 14.1 years; 63% were male. Headache was the most common postconcussion symptom, acknowledged by 69.4% of patients. When considering the full cohort, the PCA demonstrated clustering of headache with photophobia, phonophobia, nausea, dizziness, and neck pain. Similar clustering was present among patients without premorbid headaches. Repeating the analysis in the patients with preconcussion headaches led to elimination of neck pain from the cluster.
  
  
  CONCLUSIONS
  PTH correlates strongly with other migraine symptoms among youth with concussion, regardless of premorbid headaches. This clustering of migraine symptoms supports the existence of PTM as a distinct clinical entity in some patients.
authors.affiliation: Division of Pediatric Neurology, Nationwide Children's Hospital and Department of Neurology, The Ohio State University, USA geoffrey.heyer@nationwidechildrens.org.
authors.forename: Geoffrey L
authors.initials: GL
authors.lastname: Heyer
authors.affiliation: Division of Sports Medicine, Nationwide Children's Hospital, USA.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Young
authors.affiliation: Division of Pediatric Neurology, Nationwide Children's Hospital and Department of Neurology, The Ohio State University, USA.
authors.forename: Sean C
authors.initials: SC
authors.lastname: Rose
authors.affiliation: Division of Pediatric Psychology and Neuropsychology, Nationwide Children's Hospital and Department of Pediatrics, The Ohio State University, USA.
authors.forename: Kelly A
authors.initials: KA
authors.lastname: McNally
authors.affiliation: Division of Sports Medicine, Nationwide Children's Hospital, USA.
authors.forename: Anastasia N
authors.initials: AN
authors.lastname: Fischer
mesh_terms: D000293:Adolescent; D001924:Brain Concussion / Q000150:complications*; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000209:etiology*; D038223:Post-Concussion Syndrome / Q000209:etiology; D051298:Post-Traumatic Headache / Q000209:etiology*; D025341:Principal Component Analysis; D012189:Retrospective Studies
keywords: Concussion; adolescent; migraine; pediatric; post-traumatic headache; traumatic brain injury