AUSTIN—Excessive use of analgesics may exacerbate post-traumatic headaches among adolescents who have had a concussion, according to research presented at the 2013 Annual Meeting of the Child Neurology Society.
“Analgesics should be minimized or discontinued when headaches continue several weeks following concussion,” recommended Geoffrey L. Heyer, MD, of the Division of Pediatric Neurology, Nationwide Children’s Hospital in Columbus, Ohio, and colleagues.
The researchers conducted a retrospective review of 104 adolescents with concussion who had been referred to a pediatric headache clinic for chronic post-traumatic headaches of three to 12 months in duration. The study authors compared concussion symptoms, headache symptoms before and after concussion, demographic data, and headache outcomes between patients who had probable medication-overuse headache and those who did not have probable medication-overuse headache.
A total of 77 patients had chronic post-traumatic headache between three and 12 months, and 54 patients (70%) met the criteria for probable medication-overuse headache. The investigators found that patients with medication overuse were more likely to have had daily headaches, to be female, to have had nausea or throbbing associated with their headaches, to have had increased irritability following concussion, and to have had a longer interval between injury and neurologic evaluation.
“Of the patients with medication overuse, 37 (68.5%) had resolution of headaches or improvements to preconcussion headache patterns after discontinuing analgesics, seven (13%) had no change in headaches or worsening of headaches after discontinuing analgesics, and 10 (18.5%) did not discontinue analgesics or were lost to follow-up,” stated Dr. Heyer.
—Colby Stong
Editor