Mild concussions often lead to headaches for girls



Pittsburgh Post-Gazette

Girls are more likely than boys to have headaches after suffering a traumatic brain injury, according to a new study.

A traumatic brain injury is any injury to the brain caused by a sudden blow to the head. A concussion is a brain injury that alters the way the brain functions.

Roughly 1.7 million people a year suffer a traumatic brain injury, according to the U.S. Centers for Disease Control and Prevention. About 75 percent of these are concussions, considered one of the milder traumatic injuries.

Children up to 4 years old, adolescents aged 15-19 and adults 65 and older are the most likely to suffer such an injury. In every age group, rates are higher for males than for females.

The study, published in the journal Pediatrics, found that children who suffered mild injuries were more likely to report headaches than those who suffered more severe injuries.

The study examined the prevalence of headaches in children aged 5-17 three months after injury, and again at 12 months. Three months after a mild injury, 43 percent of children reported headaches, compared to 37 percent of children with moderate to severe injuries, and 26 percent for the control group. Adolescents were more likely than were younger children to report headaches.

Of those with mild injuries who reported headaches, 59 percent were girls. With girls -- but not with boys -- the risk of headache increased with age.

Kelly Rothrock, 16, of Mt. Lebanon, Pa., suffered a concussion in February, when she received an accidental blow to the head while playing with friends. At first, she had headaches almost every day. Now she gets headaches only about twice a week, she told Michael Collins during a visit recently to the University of Pittsburgh Medical Center's Sports Medicine clinic.

Collins, who has a Ph.D. in clinical psychology, was a co-designer of the ImPACT test for measuring the severity of concussions and recovery from them. He is director of the clinic's concussion program, the first and largest research program in the nation focused on the diagnosis, evaluation and management of brain injuries in athletes at all levels.

While Kelly has improved significantly she told Collins she still finds it hard to focus when reading.

The blow Kelly suffered was relatively mild. But she had a history of migraines before her accident.

"Concussion and migraines are evil cousins," Collins said.

People who are susceptible to migraines can get concussions from traumas too mild to affect those who are not prone to migraines, he said, and the concussions they suffer are often more severe.

"The evil genie comes out of the bottle," Collins said.

Girls are four to six times more likely than boys to suffer from migraines, he said. This alone could account for why girls are more likely to have headaches after a mild brain injury, though other factors may also be involved.

Researchers in the Pediatrics article noted that risk of migraine is roughly similar for boys and girls until puberty. After puberty, the susceptibility of girls to migraines increases with age, but the risk to boys plateaus.

"These findings lend support to the theory that the pathophysiology of post-traumatic headaches after TBI may share similarities with the pathophysiology of migraine," the researchers said.

Reach Jack Kelly at

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