Prevalence and Duration of Post-Concussive Headaches in a Pediatric Sports Clinic: A Cross-sectional Study

Abstract

We aim to identify the potential risk factors associated with increased susceptibility for persistent post-concussive headaches. Concussions are common, but complex, traumatic brain injuries seen in pediatric athletes of all ages & skill levels & occur in a wide variety of athletic settings. These mild traumatic brain injuries often have neurologic sequelae, including headaches. Although athletes are advised to rest, duration of post-concussive symptoms is often unpredictable. We conducted a cross sectional study on patients with head injury aged 5-18 years presented to pediatric concussion clinic (N = 603) from September 2013 to Dec 2018. We excluded patients with skull fractures and intracranial hemorrhage. The data was compiled & analyzed using frequency, Pearson correlation test, chi square & ANOVA test using IBM SPSS- 26. Patient cohort consisted of 364 males & 239 females. The age range for males was 5-18 years (Mean age ± SD: 13.45 ± 2.86) & for females was 6-18 years (Mean age ± SD: 13.97 ± 2.84). There was statically significant association between various age groups & presence of headache at 3 & 6 months (p < 0.05). Out of all ages, age group 5-8 years had highest risk of persistent headache while the age group 14-18 years reported headaches at 3 months but then resolution of symptoms by one year (p < 0.05). Females were more likely than males (of all ages) to have persistent headaches despite treatment (p = 0.00). There was also a statistically significant difference between loss of consciousness, prior history of headaches & prior history of concussions towards the development of persistent headaches (p < 0.05). Furthermore, football, soccer and basketball had significantly more headaches compared to other sports related injuries (p = 0.001). There was a statistically higher risk of developing persistent headaches for females and those with a history of prior headache, prior concussion, younger age, and those playing football, soccer or basketball.