Citation

Terry DP, Huebschmann N, Maxwell B, Cook N, Mannix R, Zafonte RD, Seifert T, Berkner PD, Iverson GL. J. Neurotrauma 2018; ePub(ePub): ePub.

Affiliation

Harvard Medical School, Red Sox Foundation and Massachusetts General Hospital Home Base Program, Boston, Massachusetts, United States ; giverson@mgh.harvard.edu.

Copyright

(Copyright © 2018, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2017.5443

PMID

29732944

Abstract

Having a pre-existing migraine disorder might be a risk factor for a prolonged recovery following a sport-related concussion. We examined whether having a migraine history was associated with a prolonged return to academics and athletics following a concussion. High school and collegiate athletes (N=1,265; 42% female) who sustained a sport-related concussion were monitored by athletic trainers using a web-based surveillance system that collects information about concussion recovery. Nonparametric Kolmogorov-Smirnov tests (KS) were used to compare days to return to academics/athletics across groups due to non-normally distributed outcome variables and unequal distributions of scores between groups. Chi-square tests were used to examine the proportion of players who had not returned to academics/athletics at 7, 14, and 21 days post-injury stratified by self-reported migraine history. There were 117 athletes (9.2%) who reported a pre-injury migraine history. Athletes with a history of migraine took a median of 6 days to return to academics (M=10.6, SD=14.2) and 15.5 days to return to athletics (M=23.8, SD=30.8), while those with no migraine history took a median of 5 days to return to academics (M=7.5, SD=10.9) and 14 days to return to athletics (M=19.4, SD=19.4). There were no statistically significant differences in days to return to school or athletics between the groups (KS ps>.05). However, a lower percentage of athletes with a history of migraine had returned to school after 7 days (57% vs. 68%, χ2=5.53, p=.02), 14 days (75% vs. 88%, χ2=14.21, p<.001), and 21 days post-injury (89% vs. 94%, χ2=4.90, p=.03). Stratifying the analyses by sex showed that this effect was significant in girls and women with pre-existing migraines, but not boys and men with pre-existing migraines. There were no group differences in recovery rates when examining return to athletics. Athletes with a pre-injury migraine history may be at an elevated risk for a protracted return to school after concussion, especially girls and women.

Language: en

Keywords

ADULT BRAIN INJURY; HEAD TRAUMA; OUTCOME MEASURES; PEDIATRIC BRAIN INJURY; TRAUMATIC BRAIN INJURY