TY - JOUR
T1 - Acute and chronic management of posttraumatic headache in children
T2 - A systematic review
AU - Patterson Gentile, Carlyn
AU - Shah, Ryan
AU - Irwin, Samantha L.
AU - Greene, Kaitlin
AU - Szperka, Christina L.
N1 - Publisher Copyright:
© 2021 American Headache Society.
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Objectives: The goal of this paper is to provide a compilation of the evidence for the treatment of posttraumatic headache (PTH) in the pediatric population. Headache features and timing of therapy were considered. Background: Headache is the most common symptom following mild traumatic brain injury (mTBI), affecting more than 80% of children and adolescents. It is unclear whether treatment for PTH should be tailored based on headache characteristics, particularly the presence of migraine features, and/or chronicity of the headache. Methods: Systematic literature searches of PubMed, Embase, Scopus, and Cochrane databases (1985–2021, limited to English) were performed, and key characteristics of included studies were entered into RedCAP® (Prospero ID CRD42020198703). Articles and conference abstracts that described randomized controlled trials (RCTs), cohort studies, retrospective analyses, and case series were included. Participants included youth under 18 years of age with acute (<3 months) and persistent (≥3 months) PTH. Studies that commented on headache improvement in response to therapy were included. Results: Twenty-seven unique studies met criteria for inclusion describing abortive pharmacologic therapies (9), preventative pharmacotherapies (5), neuromodulation (1), procedures (5), physical therapy and exercise (6), and behavioral therapy (2). Five RCTs were identified. Studies that focused on abortive pharmacotherapies were completed in the first 2 weeks post-mTBI, whereas other treatment modalities focused on outcomes 1 month to over 1-year post-injury. Few studies reported on migrainous features (7), personal history of migraine (7), or family history of migraine (3). Conclusions: There is limited evidence on the timing and types of therapies that are effective for treating PTH in the pediatric population. Prospective studies that account for headache characteristics and thoughtfully address the timing of therapies and outcome measurement are needed.
AB - Objectives: The goal of this paper is to provide a compilation of the evidence for the treatment of posttraumatic headache (PTH) in the pediatric population. Headache features and timing of therapy were considered. Background: Headache is the most common symptom following mild traumatic brain injury (mTBI), affecting more than 80% of children and adolescents. It is unclear whether treatment for PTH should be tailored based on headache characteristics, particularly the presence of migraine features, and/or chronicity of the headache. Methods: Systematic literature searches of PubMed, Embase, Scopus, and Cochrane databases (1985–2021, limited to English) were performed, and key characteristics of included studies were entered into RedCAP® (Prospero ID CRD42020198703). Articles and conference abstracts that described randomized controlled trials (RCTs), cohort studies, retrospective analyses, and case series were included. Participants included youth under 18 years of age with acute (<3 months) and persistent (≥3 months) PTH. Studies that commented on headache improvement in response to therapy were included. Results: Twenty-seven unique studies met criteria for inclusion describing abortive pharmacologic therapies (9), preventative pharmacotherapies (5), neuromodulation (1), procedures (5), physical therapy and exercise (6), and behavioral therapy (2). Five RCTs were identified. Studies that focused on abortive pharmacotherapies were completed in the first 2 weeks post-mTBI, whereas other treatment modalities focused on outcomes 1 month to over 1-year post-injury. Few studies reported on migrainous features (7), personal history of migraine (7), or family history of migraine (3). Conclusions: There is limited evidence on the timing and types of therapies that are effective for treating PTH in the pediatric population. Prospective studies that account for headache characteristics and thoughtfully address the timing of therapies and outcome measurement are needed.
KW - concussion
KW - pediatric
KW - posttraumatic headache
KW - treatment
UR - http://www.scopus.com/inward/record.url?scp=85120499652&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85120499652&partnerID=8YFLogxK
U2 - 10.1111/head.14236
DO - 10.1111/head.14236
M3 - Review article
C2 - 34862612
AN - SCOPUS:85120499652
SN - 0017-8748
VL - 61
SP - 1475
EP - 1492
JO - Headache
JF - Headache
IS - 10
ER -