Researchers at University of Washington, Seattle, and Children's Hospital of Philadelphia, PA conducted a prospective cohort study of the prevalence of headache 3 and 12 months after traumatic brain injury (TBI) in children ages 5 to 17 years. Follow-up interviews with parents or adolescents found the prevalence of headache 3 months after injury was significantly higher after mild TBI than in controls after arm injury overall (43% vs 26%), in adolescents, and in girls. It was also higher after moderate/severe TBI in younger children. At 12 months after injury, TBI was not associated with a significantly increased frequency of headaches, but girls with mild TBI reported serious headache more often than controls. [1]

COMMENT. Girls and adolescents are at highest risk of headache in the months after mild TBI. Younger children also suffer long-term headache after moderate/severe TBI. Posttraumatic headache after mild TBI shares similarities with migraine and tension-type headache. Migraine headache in children may be precipitated by head trauma [2]. Headache after hospitalization for closed head injury in children followed for 6 years did not appear to be accident related [3]. Several investigators allude to the onset of migraine following mild TBI.