Traumatic Migraine Versus Concussion

Abstract

Context:An era of increased awareness of sports concussions may decrease a provider’s ability to diagnose the athlete’s actual condition and may ultimately prolong the restriction of the injured athlete from sports. Trauma-triggered migraine is a source of headaches, especially in athletes with a family history of migraines.Evidence Acquisition:Research articles were primarily obtained through the electronic database PubMed from 1993 to August 2012. Primary research parameters included trauma-induced headaches, trauma-induced migraines, and posttraumatic migraine. The secondary search parameters included concussions, migraine treatments, and traumatic migraine treatments.Study Design:Clinical review with case report.Level of Evidence:Level 5.Results:There are no symptoms that distinguish trauma-triggered migraines from concussions, as headache is the most common complaint for both conditions. There is a paucity of studies that offer treatment guidelines for athletes with recurring headaches after trauma sustained during sporting events. Preventive treatment of migraines has been validated and proven effective.Conclusion:Trauma-triggered migraine should be considered in the differential for recurrent trauma-induced headaches. There is a lack of research evaluating efficacy and side effects of treatment of trauma-triggered migraine, and no information was found directing when an athlete can safely return to play.

Persistent Post-Traumatic Headache and Migraine: Pre-Clinical Comparisons

“…The use of TCAs is recommended in patients presenting insomnia and PTH. Among the TCA drugs, amitriptyline is an effective antimigraine therapy, which induces sedation but presents adverse events such as dizziness, dry eyes and mouth, constipation and increased appetite and cardiac adverse events with onset arrhythmia and an extension of the QT interval [57]. The properties of amitriptyline include anti-anxiety and anti-depressant effects and sleep promoting which are characteristics of PTH [56].…”

Migraine with Aura or Sports-Related Concussion: Case Report, Pathophysiology, and Multidisciplinary Approach to Management

“…In the majority of cases, the visual aura precedes the onset of headache but in selected cases can accompany the headache and be prolonged or can occur without headache. Studies have demonstrated considerable overlap between the symptoms of migraine headaches and SRC (30,43). Although acute SRC patients rarely meet the International Classification of Headache Disorders (ICHD)-3-beta criteria for migraine headaches, symptoms, such as headache, nausea, photophobia, phonophobia, and blurred vision, are commonly endorsed by these patients.…”

Spectrum of migraine variants and beyond: The individual syndromes in children

“…Indeed, trauma-triggered migraine [5] and status migrainosus are complication of migraine without aura. They have their own distinct clinical profiles.…”