title: Migraine with Aura or Sports-Related Concussion: Case Report, Pathophysiology, and Multidisciplinary Approach to Management.
abstract: The evaluation and management of athletes presenting with clinical features of migraine headache with aura in the setting of sports-related head trauma is challenging. We present a case report of a 15-yr-old boy with a history of migraine with visual aura that developed acute visual disturbance and headache after a head injury during an ice hockey game. The patient underwent comprehensive assessment at a multidisciplinary concussion program, including neuro-ophthalmological examination, neurocognitive testing, and graded aerobic treadmill testing. Clinical history and multidisciplinary assessment was consistent with the diagnosis of coexisting sports-related concussion and migraine with brainstem aura. The authors discuss the pearls and pitfalls of managing patients who develop migraine headache with visual aura after sports-related head injury and the value of a comprehensive multidisciplinary approach to this unique patient population.
authors.affiliation: 1Department of Surgery, University of Manitoba, Manitoba, Canada, 2Department of Pediatrics and Child Health, University of Manitoba, Manitoba, Canada, 3Section of Neurosurgery, University of Manitoba, Manitoba, Canada, 4Pan Am Concussion Program, University of Manitoba, Manitoba, Canada, 5Children's Hospital Research Institute of Manitoba, Manitoba, Canada; 6Canada North Concussion Network, Winnipeg, Manitoba, Canada; 7Department of Clinical Health Psychology, University of Manitoba, Manitoba, Canada, 8Department of Medicine and Ophthalmology, University of Manitoba, Manitoba, Canada, 9Department of Neurology, University of Manitoba, Manitoba, Canada.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Ellis
authors.forename: Dean
authors.initials: D
authors.lastname: Cordingley
authors.forename: Richard
authors.initials: R
authors.lastname: Girardin
authors.forename: Lesley
authors.initials: L
authors.lastname: Ritchie
authors.forename: Janine
authors.initials: J
authors.lastname: Johnston
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D001924:Brain Concussion / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D003937:Diagnosis, Differential; D003943:Diagnostic Techniques, Neurological; D006688:Hockey / Q000293:injuries; D006801:Humans; D008297:Male; D020325:Migraine with Aura / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D010348:Patient Care Team / Q000458:organization & administration