Systematic Review of Interventions for Post‐traumatic Headache

Watanabe, Thomas K.; Bell, Kathleen R.; Walker, William C.; Schomer, Katherine

doi:10.1016/j.pmrj.2011.06.003

Cited by 80 publications

(62 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…13 Evidence-based guidelines for the treatment of postconcussive headaches are sparse, given the lack of Class I randomized controlled treatment trials. 14,15 Most practice guidelines recommend treating these headaches according to the headache syndrome they phenotypically resemble (usually migraine or tension-type) while making every effort to select an agent that simultaneously addresses other accompanying symptoms. 15 As demonstrated by the range of amyloid PET findings in this case series, interpretation of amyloid imaging in TBI-exposed patients is complex.…”

Section: Discussionmentioning

confidence: 99%

“…14,15 Most practice guidelines recommend treating these headaches according to the headache syndrome they phenotypically resemble (usually migraine or tension-type) while making every effort to select an agent that simultaneously addresses other accompanying symptoms. 15 As demonstrated by the range of amyloid PET findings in this case series, interpretation of amyloid imaging in TBI-exposed patients is complex. Among patients who die within 1 hour of severe TBI, 30% have amyloid plaques on autopsy.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluating and treating neurobehavioral symptoms in professional American football players

et al. 2015

View full text Add to dashboard Cite

SummaryIn the aftermath of multiple high-profile cases of chronic traumatic encephalopathy (CTE) in professional American football players, physicians in clinical practice are likely to face an increasing number of retired football players seeking evaluation for chronic neurobehavioral symptoms. Guidelines for the evaluation and treatment of these patients are sparse. Clinical criteria for a diagnosis of CTE are under development. The contribution of CTE vs other neuropathologies to neurobehavioral symptoms in these players remains unclear. Here we describe the experience of our academic memory clinic in evaluating and treating a series of 14 self-referred symptomatic players. Our aim is to raise awareness in the neurology community regarding the different clinical phenotypes, idiosyncratic but potentially treatable symptoms, and the spectrum of underlying neuropathologies in these players.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluating and treating neurobehavioral symptoms in professional American football players

et al. 2015

View full text Add to dashboard Cite

show abstract

“…The Ontario Neurotrauma Foundation (ONTF) recently published Guidelines for Diagnosing and Managing Pediatric Concussion (http://onf.org/documents/ guidelines-diagnosing-and-managing-pediatric-concussion); however, this does not address acute postconcussive headache management. To date, there are no guidelines in the literature worldwide to guide acute postconcussive headache management (15). Physical and cognitive rest are the mainstay of initial concussion management (11)(12)(13)(14).…”

Section: Resultsmentioning

confidence: 99%

The use of ibuprofen and acetaminophen for acute headache in the postconcussive youth: A pilot study

Petrelli

Farrokhyar

McGrath³

et al. 2017

Paediatrics &Amp; Child Health

View full text Add to dashboard Cite

Objective: Acute postconcussive headaches are problematic for children after mild traumatic brain injury. There are no evidence-based guidelines for their management. This pilot study aims to assess the feasibility and efficacy of routine analgesia administration. Methods: A four-arm open-label randomized controlled trial pilot/feasibility study was conducted: (i) acetaminophen, (ii) ibuprofen, (iii) alternating acetaminophen and ibuprofen and (iv) a control group. Children and youth 8 to 18 years of age presenting to emergency department with headache within 48 hours of their first concussion were recruited consecutively and sequentially randomized. Children with abnormal neuroimaging, history of previous concussions and bleeding disorder were excluded. A headache survey was administered at recruitment. All participants were provided with standard concussion management education and were also instructed on how to use the headache diary for the 1-week study follow-up period. The diary captures (i) headache days, (ii) number of headaches, (iii) headache intensity and (iv) return-to-school information. Feasibility was assessed based on study recruitment and compliance. Results: There were no feasibility concerns with the recruitment and no major compliance issues. Patients on acetaminophen, ibuprofen or both had significantly less headache days, episodes of headache and lower headache intensity than did the standard care group. Patients on both ibuprofen and acetaminophen (79.0%) and on ibuprofen alone (61.0%) were more likely to be back at school 1 week postinjury as compared with the acetaminophen group (33.3%) and the standard care group (21.1%). Conclusion: Results showed routine analgesia administration was feasible and effective for postconcussive headache management. A larger full-scale randomized controlled trial is required to further assess the efficacy with longer follow-up, a wider variety of patients and more concussion related outcomes. L'utilisation d'ibuprofène et d'acétaminophène pour soulager les céphalées aiguës postcommotionnelles : une étude piloteObjectif : Les céphalées postcommotionnelles posent problème chez les enfants après une légère commotion cérébrale. Il n'y a pas de lignes directrices factuelles sur leur prise en charge. La présente étude pilote vise à évaluer la faisabilité et l'efficacité de l'administration systématique d'analgésiques. Méthodologie : Les chercheurs ont réalisé une étude pilote et de faisabilité ouverte, aléatoire et contrôlée en quatre volets : i) acétaminophène, ii) ibuprofène, iii) alternance entre l'acétaminophène et l'ibuprofène et iv) groupe témoin. Des enfants et des adolescents de huit à 18 ans qui ont consulté à l'urgence à cause de céphalées dans les 48 heures suivant une première commotion ont été recrutés de manière consécutive, séquentielle et aléatoire. Les enfants dont la neuro-imagerie était anormale ou qui avaient des antécédents de commotion ou des troubles hémostatiques étaient exclus. Les enfants ont répondu

show abstract

“…Medication rebound headache can also occur, particularly if the initial headache type is improperly managed with overuse of over-thecounter medication. 34 Athletes with migrainous features after concussion may suffer from greater cognitive impairment, and report higher postinjury symptom scores, than athletes with nonmigrainous headaches. 35 A recent systematic review found that there is insufficient evidence to support treatment protocols for headaches following concussion, but some guidelines are offered 33 :…”

Section: Headachementioning

confidence: 99%