Jan 29, 2015
Migraines May Signal Concussion Damage

Most athletic trainers recognize acute headache pain, nausea, and hypersensitivity to light or sound as the hallmarks of migraine headaches. Now, researchers at the University of Pittsburgh say that these symptoms can also indicate increased neurocognitive impairment following a concussion.

As part of the University of Pittsburgh Sports Medicine Concussion Program, researchers divided 261 high school and college athletes who had suffered a concussion into three groups: those who showed symptoms of post-traumatic migraine (PTM) headache, those who had headaches, and those who had no headaches. Neurocognitive testing (including verbal and visual memory, visual motor speed, and reaction time tests) showed that the migraine group performed significantly worse than both the headache and non-headache groups.

“The findings of our study strongly support the need for clinicians to exercise increased vigilance in making decisions about managing a concussed athlete with PTM and extreme caution as to when that athlete should be allowed to return to play,” said the study’s lead author, Jason Mihalik, CAT(C), ATC, a doctoral student now working in the Sports Medicine Research Laboratory at the University of North Carolina.

According to the studys authors, “Given the significantly greater neurocognitive impairments observed in the PTM group in our study, any athlete with a concussion accompanied by characteristics of PTM should be examined in a setting that includes symptom status and neurocognitive testing to address their recovery more fully. Clearly, sports-related concussion is related to increased cognitive impairments, regardless of the presence of headache. It is critical that any athlete sustaining a concussion be followed up to not only assess lingering symptoms, but also to evaluate cognitive impairments. Symptoms may resolve before their neurocognitive deficits do.”

The study, titled “Post-Traumatic Migraine Characteristics In Athletes Following Sports-Related Concussion” was published in the April 2005 issue of the Journal of Neurosurgery and is the latest in a series of University of Pittsburgh Medical Center studies on concussions in athletes. A 2003 UPMC study showed that headache is likely associated with incomplete brain recovery following a concussion and indicated the need to keep athletes out of action until headache and other symptoms have cleared.

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