Symptoms and neurocognitive functioning were compared in athletes with no headache (non-HA group), athletes complaining of HA (HA group), and athletes with posttraumatic migraine (PTM group), in a study of 261 high school and college athletes (mean age, 16.36+/-2.6 years) at University of Pittsburgh Medical Center; University of North Carolina, Chapel Hill; and Florida Neuroscience Institute, Orlando. A computer software program (ImPACT) designed to assess sports-related concussion found significant differences in neurocognitive outcome measures for verbal and visual memory, visual motor speed, reaction time, and total symptom scores among the 3 groups. The PTM group had significantly lower verbal memory and visual memory scores post-injury than those in HA and non-HA groups. Differences in these scores were not found between HA and non-HA groups. Similar differences in the 3 groups were observed for visual motor speed scores. The PTM group also had significantly lower reaction time scores than the HA and non-HA groups, and the HA group scores were significantly lower than the non-HA group. The PTM group reported the largest mean increase in post-concussion symptom scores compared with baseline reports. 
COMMENT. High school and college athletes suffering a sports-related concussion accompanied by posttraumatic migraine (PTM) should be followed for symptoms of head injury and also neurocognitive impairments. Baseline and post-injury testing protocols should be available for students at risk for concussion. Neurocognitive test results are essential to determine recovery and fitness to resume sports in athletes suffering from PTM or other post-concussion syndromes.