Skip to main content
Top
Published in: Pediatric Drugs 5/2018

01-10-2018 | Leading Article

Pharmacotherapy for Persistent Posttraumatic Headaches in Children and Adolescents: A Brief Review of the Literature

Author: Joanne Kacperski

Published in: Pediatric Drugs | Issue 5/2018

Login to get access

Abstract

Concussion, now most often referred to as mild traumatic brain injury in recent literature, is common in pediatrics, and headache is often the most common complaint post-injury. Although most children and adolescents recover within 1–2 weeks, some develop frequent and debilitating headaches that can last for months or longer. Most clinicians would agree on the importance of managing both acute and persistent posttraumatic headaches appropriately to speed recovery, minimize disability, maximize function, and improve quality of life, but there are no well-established guidelines to instruct physicians in doing so. As this continues to be a developing field, there is much we still need to learn about concussion and the appropriate strategies to prevent and treat these injuries and their sequelae. This review is intended to help providers understand the current evidence, and sometimes the lack thereof, and ultimately to lead to improved care for children with headaches after mild traumatic brain injury.
Literature
1.
go back to reference Langlois JA, Rutland-Brown W, Thomas KE. The incidence of traumatic brain injury among children in the United States: differences by race. J Head Trauma Rehabil. 2005;20(3):229–38.CrossRefPubMed Langlois JA, Rutland-Brown W, Thomas KE. The incidence of traumatic brain injury among children in the United States: differences by race. J Head Trauma Rehabil. 2005;20(3):229–38.CrossRefPubMed
2.
go back to reference Barlow KM, Crawford S, Stevenson A, Sandhu SS, Belanger F, Dewey D. Epidemiology of postconcussion syndrome in pediatric mild traumatic brain injury. Pediatrics. 2010;126:e374–81.CrossRefPubMed Barlow KM, Crawford S, Stevenson A, Sandhu SS, Belanger F, Dewey D. Epidemiology of postconcussion syndrome in pediatric mild traumatic brain injury. Pediatrics. 2010;126:e374–81.CrossRefPubMed
3.
go back to reference Cassidy JD, Carroll LJ, Peloso PM, Borg J, vanHolst H, Holm L, Kraus J, Coronado VG. Incidence, risk factors and prevention of mild traumatic brain injury: results of the WHO collaborating centre task force on mild traumatic brain injury. J Rehabil Med. 2004;Suppl43:28–60.CrossRef Cassidy JD, Carroll LJ, Peloso PM, Borg J, vanHolst H, Holm L, Kraus J, Coronado VG. Incidence, risk factors and prevention of mild traumatic brain injury: results of the WHO collaborating centre task force on mild traumatic brain injury. J Rehabil Med. 2004;Suppl43:28–60.CrossRef
4.
go back to reference Thurman DJ, Branche CM, Sniezek JE. The epidemiology of sports related traumatic brain injuries in the United States: recent developments. J Head Trauma Rehabil. 1998;13(2):1–8.CrossRefPubMed Thurman DJ, Branche CM, Sniezek JE. The epidemiology of sports related traumatic brain injuries in the United States: recent developments. J Head Trauma Rehabil. 1998;13(2):1–8.CrossRefPubMed
5.
go back to reference Meehan WP, d’Hemecourt P, Comstock RD. High school concussions in the 2008–2009 academic year: mechanism, symptoms, and management. Am J Sports Med. 2010;38:2405–9.CrossRefPubMedPubMedCentral Meehan WP, d’Hemecourt P, Comstock RD. High school concussions in the 2008–2009 academic year: mechanism, symptoms, and management. Am J Sports Med. 2010;38:2405–9.CrossRefPubMedPubMedCentral
6.
go back to reference Mihalik JP, Register-Mihalik J, Kerr ZY, Marshall SW, McCrea MC, Guskiewicz KM. Recovery of posttraumatic migraine characteristic in patients after mild traumatic brain injury. Am J Sports Med. 2013;41:1490–6.CrossRef Mihalik JP, Register-Mihalik J, Kerr ZY, Marshall SW, McCrea MC, Guskiewicz KM. Recovery of posttraumatic migraine characteristic in patients after mild traumatic brain injury. Am J Sports Med. 2013;41:1490–6.CrossRef
7.
go back to reference Choe MC, Blume HK. Pediatric posttraumatic headache: a review. J Child Neur. 2016;31(1):76–85.CrossRef Choe MC, Blume HK. Pediatric posttraumatic headache: a review. J Child Neur. 2016;31(1):76–85.CrossRef
8.
go back to reference Guskiewicz KM, Weaver NL, Padua DA, Garrett WE. Epidemiology of concussion in collegiate and high school football players”. Am J Sports Med. 2000;28:643–50.CrossRefPubMed Guskiewicz KM, Weaver NL, Padua DA, Garrett WE. Epidemiology of concussion in collegiate and high school football players”. Am J Sports Med. 2000;28:643–50.CrossRefPubMed
10.
go back to reference Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition (beta version). Cephalalgia. 2013;33:629–808.CrossRef Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition (beta version). Cephalalgia. 2013;33:629–808.CrossRef
11.
go back to reference Lucas S. Headache management in concussion and mild traumatic brain injury. PMR. 2011;3:S406–12.CrossRef Lucas S. Headache management in concussion and mild traumatic brain injury. PMR. 2011;3:S406–12.CrossRef
12.
go back to reference Babcock L, Byczkowski T, Wade SL, Ho M, Mookerjee S, Bazarian JJ. Predicting postconcussion syndrome after mild traumatic brain injury in children and adolescents who present to the emergency department. Arch Pediatr Adolesc Med. 2012;167(2):156–61. Babcock L, Byczkowski T, Wade SL, Ho M, Mookerjee S, Bazarian JJ. Predicting postconcussion syndrome after mild traumatic brain injury in children and adolescents who present to the emergency department. Arch Pediatr Adolesc Med. 2012;167(2):156–61.
13.
go back to reference Blume HK. Headaches after concussion in pediatrics: a review. Curr Pain Headahce Rep. 2015;19(9):19–42. Blume HK. Headaches after concussion in pediatrics: a review. Curr Pain Headahce Rep. 2015;19(9):19–42.
14.
go back to reference Kacperski J, Arthur T. Management of post-traumatic headaches in children and adolescents. Headache. 2016;56(1):36–48.CrossRefPubMed Kacperski J, Arthur T. Management of post-traumatic headaches in children and adolescents. Headache. 2016;56(1):36–48.CrossRefPubMed
15.
go back to reference Blume HK, Vavilala MS, Jaffe KM, Koepsell TD, Wang J, Temkin N, Durbin D, Dorsch A, Rivara FP. Headache after pediatric traumatic brain injury: a cohort study. Pediatrics. 2012;129(1):e31–9.CrossRefPubMed Blume HK, Vavilala MS, Jaffe KM, Koepsell TD, Wang J, Temkin N, Durbin D, Dorsch A, Rivara FP. Headache after pediatric traumatic brain injury: a cohort study. Pediatrics. 2012;129(1):e31–9.CrossRefPubMed
16.
go back to reference Preiss-Farzanegan SJ, Chapman B, Wong TM, Wu J, Bazarian JJ. The relationship between gender and postconcussion symptoms after sport-related mild traumatic brain injury. PMR. 2009;1(3):245–53.CrossRef Preiss-Farzanegan SJ, Chapman B, Wong TM, Wu J, Bazarian JJ. The relationship between gender and postconcussion symptoms after sport-related mild traumatic brain injury. PMR. 2009;1(3):245–53.CrossRef
17.
go back to reference Bramley H, Heverley S, Lewis MM, Kong L, Rivera R, Silvis M. Demographics and treatment of adolescent posttraumatic headache in a regional concussion clinic. Pediatr Neurol. 2015;52(5):493–8.CrossRefPubMed Bramley H, Heverley S, Lewis MM, Kong L, Rivera R, Silvis M. Demographics and treatment of adolescent posttraumatic headache in a regional concussion clinic. Pediatr Neurol. 2015;52(5):493–8.CrossRefPubMed
18.
go back to reference Kuczynski A, Crawford S, Bodell L, Dewey D, Barlow KM. Characteristics of post-traumatic headaches in children following mild traumatic brain injury and their response to treatment: a prospective cohort. Dev Med Child Neurol. 2013;55(7):636–41.CrossRefPubMed Kuczynski A, Crawford S, Bodell L, Dewey D, Barlow KM. Characteristics of post-traumatic headaches in children following mild traumatic brain injury and their response to treatment: a prospective cohort. Dev Med Child Neurol. 2013;55(7):636–41.CrossRefPubMed
19.
go back to reference Blume H, Temkin N,Wang J, Monica VS, Jaffe KM, Durbin D, Dorsch A, Rivara FP. Headache following mild TBI in children: what are the risks? Abstracts of the 2013 International Headache Congress, 27–30 June 2013, Boston, MA, USA. Cephalalgia. 2013;33 (8 Supp.):244. Blume H, Temkin N,Wang J, Monica VS, Jaffe KM, Durbin D, Dorsch A, Rivara FP. Headache following mild TBI in children: what are the risks? Abstracts of the 2013 International Headache Congress, 27–30 June 2013, Boston, MA, USA. Cephalalgia. 2013;33 (8 Supp.):244.
20.
go back to reference Wilson MC, Krolczyk SJ. Pediatric post-traumatic headache. Curr Pain Headache Rep. 2006;10(5):387–90.CrossRefPubMed Wilson MC, Krolczyk SJ. Pediatric post-traumatic headache. Curr Pain Headache Rep. 2006;10(5):387–90.CrossRefPubMed
21.
go back to reference Hoffman JM, Lucas S, Dikmen S, Braden CA, Brown AW, Brunner R, Diaz-Arrastia R, Walker WC, Watanabe TK, Bell KR. Natural history of headache after traumatic brain history. J Neurotrauma. 2011;28(9):1719–25.CrossRefPubMedPubMedCentral Hoffman JM, Lucas S, Dikmen S, Braden CA, Brown AW, Brunner R, Diaz-Arrastia R, Walker WC, Watanabe TK, Bell KR. Natural history of headache after traumatic brain history. J Neurotrauma. 2011;28(9):1719–25.CrossRefPubMedPubMedCentral
22.
go back to reference Pinchefsky E, Dubrovsky AS, Friedman D, Shevell M. Part II- Management of pediatric post-traumatic headaches. Pediatr Neurol. 2015;52:270–80.CrossRefPubMed Pinchefsky E, Dubrovsky AS, Friedman D, Shevell M. Part II- Management of pediatric post-traumatic headaches. Pediatr Neurol. 2015;52:270–80.CrossRefPubMed
23.
go back to reference Theeler BJ, Flynn F, Erickson JC. Headaches after concussion in US soldiers returning from Iraq or Afghanistan. Headache. 2010;50:1262–72.CrossRefPubMed Theeler BJ, Flynn F, Erickson JC. Headaches after concussion in US soldiers returning from Iraq or Afghanistan. Headache. 2010;50:1262–72.CrossRefPubMed
24.
go back to reference Ponsford J, Willmott C, Rothwell A, Cameron P, Ayton G, Nelms R, Curran C, Ng K. Impact of early intervention on outcome after mild traumatic brain injury in children. Pediatrics. 2001;108:1297–303.CrossRefPubMed Ponsford J, Willmott C, Rothwell A, Cameron P, Ayton G, Nelms R, Curran C, Ng K. Impact of early intervention on outcome after mild traumatic brain injury in children. Pediatrics. 2001;108:1297–303.CrossRefPubMed
25.
go back to reference Hershey A. Current approaches to the diagnosis and management of paediatric migraine. Lancet Neurol. 2010;9:190–204.CrossRefPubMed Hershey A. Current approaches to the diagnosis and management of paediatric migraine. Lancet Neurol. 2010;9:190–204.CrossRefPubMed
26.
go back to reference Kacperski J, Hung R, Blume HK. Pediatric posttraumatic headache. Semin Pediatr Neurol. 2016;23:27–34.CrossRefPubMed Kacperski J, Hung R, Blume HK. Pediatric posttraumatic headache. Semin Pediatr Neurol. 2016;23:27–34.CrossRefPubMed
27.
go back to reference O’Brien HL, Kabbouche MA, Kacperski J, Hershey AD. Treatment of pediatric migraine. Curr Treat Opt Neurol. 2015;17(1):326.CrossRef O’Brien HL, Kabbouche MA, Kacperski J, Hershey AD. Treatment of pediatric migraine. Curr Treat Opt Neurol. 2015;17(1):326.CrossRef
28.
go back to reference Vincent MB. Controversy over the classification of medication-overuse headache. Curr Pain Headache Rep. 2012;16:80–5.CrossRefPubMed Vincent MB. Controversy over the classification of medication-overuse headache. Curr Pain Headache Rep. 2012;16:80–5.CrossRefPubMed
29.
go back to reference Heyer GL, Idris SA. Does analgesic overuse contribute to post-traumatic headaches in adolescent concussion patients? Pediatr Neurol. 2014;50:464–8.CrossRefPubMed Heyer GL, Idris SA. Does analgesic overuse contribute to post-traumatic headaches in adolescent concussion patients? Pediatr Neurol. 2014;50:464–8.CrossRefPubMed
30.
go back to reference Erickson J, Neely E, Theeler B. Posttraumatic headache. Continuum Lifel Learn Neurol. 2010;16:55–78.CrossRef Erickson J, Neely E, Theeler B. Posttraumatic headache. Continuum Lifel Learn Neurol. 2010;16:55–78.CrossRef
31.
32.
go back to reference Kacperski J, Hershey AD. Preventative drugs in childhood and adolescent migraine. Curr Pain Headache Rep. 2014;18(6):422–7.CrossRefPubMed Kacperski J, Hershey AD. Preventative drugs in childhood and adolescent migraine. Curr Pain Headache Rep. 2014;18(6):422–7.CrossRefPubMed
33.
go back to reference Kacperski J, Kabbouche MA, O’Brien HL, Hershey AD. Headache in the pediatric patient. case-based diagnosis and management of headache disorders. Siva, Lampl eds, Switzerland. 2014. Kacperski J, Kabbouche MA, O’Brien HL, Hershey AD. Headache in the pediatric patient. case-based diagnosis and management of headache disorders. Siva, Lampl eds, Switzerland. 2014.
34.
go back to reference Lewis D, Diamond S, Scott D, Jones V. Prophylactic treatment of pediatric migraine. Headache. 2004;44:230–7.CrossRefPubMed Lewis D, Diamond S, Scott D, Jones V. Prophylactic treatment of pediatric migraine. Headache. 2004;44:230–7.CrossRefPubMed
35.
go back to reference Watanabe TK, Bell KR, Walker WC, Schomer K. Systematic review of interventions for post-traumatic headache. PMR. 2012;49(2):129–40.CrossRef Watanabe TK, Bell KR, Walker WC, Schomer K. Systematic review of interventions for post-traumatic headache. PMR. 2012;49(2):129–40.CrossRef
36.
go back to reference Giza CC, Kutcher JS, Ashwal S, Barth J, Getchius TS, Gioia GA, Gronseth GS, Guskiewicz K, Mandel S, Manley G, McKeag DB, Thurman DJ, Zafonte R. Summary of evidence-based guideline update: evaluation and management of concussion in sports: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2013;80(24):2250–7.CrossRefPubMedPubMedCentral Giza CC, Kutcher JS, Ashwal S, Barth J, Getchius TS, Gioia GA, Gronseth GS, Guskiewicz K, Mandel S, Manley G, McKeag DB, Thurman DJ, Zafonte R. Summary of evidence-based guideline update: evaluation and management of concussion in sports: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2013;80(24):2250–7.CrossRefPubMedPubMedCentral
37.
go back to reference Couch JR, Bearss C. Chronic daily headache in the post trauma syndrome: relation to extent of head injury. Headache. 2001;41:559–64.CrossRefPubMed Couch JR, Bearss C. Chronic daily headache in the post trauma syndrome: relation to extent of head injury. Headache. 2001;41:559–64.CrossRefPubMed
38.
go back to reference Faux S, Sheedy J. A prospective controlled study in the prevalence of posttraumatic headache following mild traumatic brain injury. Pain Med. 2008;9:1001–11.CrossRefPubMed Faux S, Sheedy J. A prospective controlled study in the prevalence of posttraumatic headache following mild traumatic brain injury. Pain Med. 2008;9:1001–11.CrossRefPubMed
39.
go back to reference Kuppermann N, Holmes JF, Dayan PS, Hoyle JD Jr, Atabaki SM, Holubkov R, Nadel FM, Monroe D, Stanley RM, Borgiali DA, Badawy MK, Schunk JE, Quayle KS, Mahajan P, Lichenstein R, Lillis KA, Tunik MG, Jacobs ES, Callahan JM, Gorelick MH, Glass TF, Lee LK, Bachman MC, Cooper A, Powell EC, Gerardi MJ, Melville KA, Muizelaar JP, Wisner DH, Zuspan SJ, Dean JM, Wootton-Gorges SL. Identification of children at very low risk of clinically important brain injuries after head trauma: a prospective cohort study”. Lancet. 2009;374(9696):1160–70.CrossRefPubMed Kuppermann N, Holmes JF, Dayan PS, Hoyle JD Jr, Atabaki SM, Holubkov R, Nadel FM, Monroe D, Stanley RM, Borgiali DA, Badawy MK, Schunk JE, Quayle KS, Mahajan P, Lichenstein R, Lillis KA, Tunik MG, Jacobs ES, Callahan JM, Gorelick MH, Glass TF, Lee LK, Bachman MC, Cooper A, Powell EC, Gerardi MJ, Melville KA, Muizelaar JP, Wisner DH, Zuspan SJ, Dean JM, Wootton-Gorges SL. Identification of children at very low risk of clinically important brain injuries after head trauma: a prospective cohort study”. Lancet. 2009;374(9696):1160–70.CrossRefPubMed
40.
go back to reference Erickson J. A Pilot randomized controlled trial of prophylactic medications for chronic post-traumatic headaches in U.S. army soldiers (P03.226). Neurology. 2012;78(Meeting Abstracts 1):P03.226.CrossRef Erickson J. A Pilot randomized controlled trial of prophylactic medications for chronic post-traumatic headaches in U.S. army soldiers (P03.226). Neurology. 2012;78(Meeting Abstracts 1):P03.226.CrossRef
41.
go back to reference Erickson J. Treatment outcomes of chronic post-traumatic headaches after mild head trauma in US soldiers: an observational study. Headache. 2011;51:932–44.CrossRefPubMed Erickson J. Treatment outcomes of chronic post-traumatic headaches after mild head trauma in US soldiers: an observational study. Headache. 2011;51:932–44.CrossRefPubMed
42.
go back to reference O’Brien HL, Kabbouche MA, Hershey AD. Treating pediatric migraine: an expert opinion. Expert Opin Pharmacother. 2012;13(7):959–66.CrossRefPubMed O’Brien HL, Kabbouche MA, Hershey AD. Treating pediatric migraine: an expert opinion. Expert Opin Pharmacother. 2012;13(7):959–66.CrossRefPubMed
43.
go back to reference Packard R. Treatment of chronic daily posttraumatic headache with divalproex sodium. Headache. 2000;40:736–9.CrossRefPubMed Packard R. Treatment of chronic daily posttraumatic headache with divalproex sodium. Headache. 2000;40:736–9.CrossRefPubMed
44.
go back to reference Ludvigsson J. Propranolol used in prophylaxis of migraine in children. Acta Neurol. 1974;50:109–15.CrossRef Ludvigsson J. Propranolol used in prophylaxis of migraine in children. Acta Neurol. 1974;50:109–15.CrossRef
45.
go back to reference Forsythe WI, Gillies D, Sills MA. Propranolol (‘Inderal’) in the treatment of childhood migraine. Dev Med Child Neurol. 1984;26:737–41.CrossRefPubMed Forsythe WI, Gillies D, Sills MA. Propranolol (‘Inderal’) in the treatment of childhood migraine. Dev Med Child Neurol. 1984;26:737–41.CrossRefPubMed
46.
go back to reference Kabbouche MA, O’Brien HL, Hershey AD. OnabotulinumtoxinA in pediatric chronic daily headache. Curr Neurol Neurosci Rep. 2012;12(2):114–7.CrossRefPubMed Kabbouche MA, O’Brien HL, Hershey AD. OnabotulinumtoxinA in pediatric chronic daily headache. Curr Neurol Neurosci Rep. 2012;12(2):114–7.CrossRefPubMed
47.
go back to reference Dougherty C, Ailani J. The effect of onabotulinumtoxinA on chronic post-traumatic headaches refractory to standard preventative therapy (P03.223). Neurology. 2012;78(Meeting Abstracts 1):P03.223.CrossRef Dougherty C, Ailani J. The effect of onabotulinumtoxinA on chronic post-traumatic headaches refractory to standard preventative therapy (P03.223). Neurology. 2012;78(Meeting Abstracts 1):P03.223.CrossRef
48.
go back to reference Yerry JA, Kuehn D, Finkel AG. OnabotulinumtoxinA for the treatment of headache in service members with a history of mild traumatic brain injury: a cohort study. Headache. 2015;55(3):395–406.CrossRefPubMed Yerry JA, Kuehn D, Finkel AG. OnabotulinumtoxinA for the treatment of headache in service members with a history of mild traumatic brain injury: a cohort study. Headache. 2015;55(3):395–406.CrossRefPubMed
49.
go back to reference Dubrosky AS, Friedman D, Kocilowicz H. Pediatric post-traumatic headaches and peripheral nerve blocks of the scalp: a case series and patient satisfaction survey. Headache. 2014;54(5):878–87.CrossRef Dubrosky AS, Friedman D, Kocilowicz H. Pediatric post-traumatic headaches and peripheral nerve blocks of the scalp: a case series and patient satisfaction survey. Headache. 2014;54(5):878–87.CrossRef
50.
go back to reference Seeger TA, Orr S, Bodell L, Lockyer L, Rajapakse T, Barlow KM. Occipital nerve blocks for pediatric posttraumatic headache: a case series. J Child Neurol. 2015;30(9):1142–6.CrossRefPubMed Seeger TA, Orr S, Bodell L, Lockyer L, Rajapakse T, Barlow KM. Occipital nerve blocks for pediatric posttraumatic headache: a case series. J Child Neurol. 2015;30(9):1142–6.CrossRefPubMed
51.
go back to reference Brown AW, Watanbe TK, Hoffman JM, Bell KR, Lucas S, Dikmen S. Headache after traumatic brain injury: a national survey of clinical practices and treatment approaches. PM R. 2015;7:3–8.CrossRefPubMed Brown AW, Watanbe TK, Hoffman JM, Bell KR, Lucas S, Dikmen S. Headache after traumatic brain injury: a national survey of clinical practices and treatment approaches. PM R. 2015;7:3–8.CrossRefPubMed
52.
go back to reference Dodick DW, Goadsby PJ, Silberstein SD, et al. Safety and efficacy of ALD403, an antibody to calcitonin gene-related peptide, for the prevention of frequent episodic migraine: a randomised, doubleblind, placebo-controlled, exploratory phase 2 trial. Lance Neurol. 2014;13:1100–7.CrossRef Dodick DW, Goadsby PJ, Silberstein SD, et al. Safety and efficacy of ALD403, an antibody to calcitonin gene-related peptide, for the prevention of frequent episodic migraine: a randomised, doubleblind, placebo-controlled, exploratory phase 2 trial. Lance Neurol. 2014;13:1100–7.CrossRef
Metadata
Title
Pharmacotherapy for Persistent Posttraumatic Headaches in Children and Adolescents: A Brief Review of the Literature
Author
Joanne Kacperski
Publication date
01-10-2018
Publisher
Springer International Publishing
Published in
Pediatric Drugs / Issue 5/2018
Print ISSN: 1174-5878
Electronic ISSN: 1179-2019
DOI
https://doi.org/10.1007/s40272-018-0299-8

Other articles of this Issue 5/2018

Pediatric Drugs 5/2018 Go to the issue