Migraine with aura is the predominant phenotype among acute post-traumatic headache in sports

Abstract

Introduction Headache is the most common symptom after traumatic brain injury (TBI), a global health concern with an estimated 2.5 million people in the United States reporting TBI in a single year. Regrettably, there is little evidence on the medical management of post-traumatic headache (PTH). Generally, treatment is approached as the primary headache disorder it most closely resembles in phenotype. In the lay public, the majority of PTHs exhibit migraine or probable migraine characteristics; however, PTH phenotypes within a sporting context have not been reported. Methods This cross-sectional survey evaluated the characteristics of headache in 102 student-athletes, ages 13-23 who had sustained sport-related concussion. Acute post-traumatic headache and sport-related concussion were defined by the International Classification of Headache Disorders and the Concussion in Sport Group definitions, respectively. The sample included male and female athletes from a variety of sports, with differing degrees of contact exposure. The survey collected data on personal and family history of headache, as well as specific headache characteristics. Results The study included 54 males and 48 females. Migraine with aura (45.4%) was the predominant phenotype is this cross sectional cohort of sportrelated acute post-traumatic headache. This was followed by migraine without aura (22.7%), tension-type headache (21.8%), and other (10.1%). Conclusions Migraine with aura is a common phenotype among sport-related acute PTH. Further studies should evaluate for potential differences in recovery trajectories when compared to other headache phenotypes.