Citation

Irwin SL, Kacperski J, Rastogi RG. Headache 2020; ePub(ePub): ePub.

Affiliation

Department of Child Health, University of Arizona College of Medicine, Phoenix, AZ, USA.

Copyright

(Copyright © 2020, American Headache Society; American Association for the Study of Headache, Publisher John Wiley and Sons)

DOI

10.1111/head.13824

PMID

32356593

Abstract

BACKGROUND: Headache attributed to mild traumatic injury of the head (aka: mild traumatic brain injury, mTBI), frequently abbreviated to Post-Traumatic Headache (PTH), is one of the most common and disabling symptoms after a head injury. PTH often phenotypes to migraine. Evidence for treating PTH in the pediatric population is limited. Widely accepted guidelines do not exist to aid the clinician and there are currently no placebo-controlled trials for the pharmacologic management of PTH in this age group. Recommendations for when to return a child or adolescent to sport if they develop and/or are being treated for persistent PTH (PPTH) are lacking. The objective of this narrative review is to review the implications of returning an adolescent with PPTH to sport.

METHODS: Pediatric neurologists with special qualification in headache collaborated on this narrative review. Literature was searched up until Oct 2019 for articles pertaining to PTH, concussion, mTBI, and the return of a pediatric athlete to sport after mTBI. Article inclusion was at the discretion of the authors. There was author consensus regarding all recommendations made.

CONCLUSION: The authors recommend that strict adherence to the guidelines that return to sport cannot occur until a child is symptom free at rest, off any medication, may be unreasonable in certain situations. Symptom stability is the proposed new concept for return to sport.

© 2020 American Headache Society.

Language: en

Keywords

adolescents; headaches; migraine; pediatrics; post-traumatic headache; return to play; return to sport