Posttraumatic migraine characteristics in athletes following sports-related concussion

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  • 1 Department of Sports Medicine and Nutrition, School of Health and Rehabilitation Sciences, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center; Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Allied Health Sciences, School of Medicine, University of North Carolina, Chapel Hill, North Carolina; and Department of Neurosurgery, Florida Hospital Neuroscience Institute and Center for Sports-Related Craniospinal Injuries, Orlando, Florida
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Object. The object of this study was to compare symptom status and neurocognitive functioning in athletes with no headache (non-HA group), athletes complaining of headache (HA group), and athletes with characteristics of posttraumatic migraine (PTM group).

Methods. Neurocognitive tests were undertaken by 261 high-school and collegiate athletes with a mean age of 16.36 ± 2.6 years. Athletes were separated into three groups: the PTM group (74 athletes with a mean age of 16.39 ± 3.06 years), the HA group (124 athletes with a mean age of 16.44 ± 2.51 years), and the non-HA group (63 patients with a mean age of 16.14 ± 2.18 years). Neurocognitive summary scores (outcome measures) for verbal and visual memory, visual motor speed, reaction time, and total symptom scores were collected using ImPACT, a computer software program designed to assess sports-related concussion.

Significant differences existed among the three groups for all outcome measures. The PTM group demonstrated significantly greater neurocognitive deficits when compared with the HA and non-HA groups. The PTM group also exhibited the greatest amount of departure from baseline scores.

Conclusions. The differences among these groups can be used as a basis to argue that PTM characteristics triggered by sports-related concussion are related to increased neurocognitive dysfunction following mild traumatic brain injury. Thus, athletes suffering a concussion accompanied by PTM should be examined in a setting that includes symptom status and neurocognitive testing to address their recovery more fully. Given the increased impairments observed in the PTM group, in this population clinicians should exercise increased caution in decisions about treatment and when the athlete should be allowed to return to play.

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Contributor Notes

Address reprint requests to: Mark R. Lovell, Ph.D., University of Pittsburgh Medical Center Sports Medicine Concussion Program, 3200 South Water Street, Pittsburgh, Pennsylvania 15203. email: lovellmr@upmc.edu.
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