Concussion recovery longer in kids with occipital headaches, photophobia

Children and teens who had a concussion and subsequently reported occipital headaches and photophobia took more time to return to their pre-concussion state than those who did not report these symptoms, data show.

The findings will be presented at the virtual American Academy of Neurology annual meeting in April.

“There is a considerable amount of medical literature pertaining to concussion in adults, but far less literature and guidelines in kids and adolescents,” Osman Farooq, MD, an associate professor of neurology at the University at Buffalo and medical director of the division of pediatric neurology at Oishei Children’s Hospital in Buffalo, told Healio Primary Care.

“Our goal was to assess pediatric concussion at our center and see if we can identify any prognosticating factors which can help determine outcome and return to normal functioning,” he said.

Farooq and Mark Andrews, a medical student at the University at Buffalo, analyzed a database that contained premorbid, presenting and longitudinal information on 235 patients aged 1 to 19 years who had a concussion.

The researchers reported that patients who reported occipital headaches were more likely to take at least 3 weeks to return to their pre-concussion state than those who did not have headaches (86% vs. 48%, P = .003). In addition, patients who experienced photophobia were more likely to take at least 2 weeks to return to baseline than those who did not (74% vs 38%, P = .0005), and those who struggled with school performance after a concussion were more likely to report frontal headaches than those who did not (80% vs. 39%, P = .01).

“I have been seeing patients with concussions for years, and I was never able to make correlations between location of headaches and length of time taken to recover from their concussions,” Farooq, who is also with the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, said.

He said he was also taken aback by the relationship between headaches and difficulty with school performance.

“It is important for primary care physicians to screen for the cognitive effects of a concussion, as these often get missed or buried beneath the more acute headaches that the individual may be suffering from,” Farooq said.

He added that physicians need to stress to patients and parents that concussions are not something that only athletes endure.

“We see concussions related to sports, bicycle injuries, falls, car accidents, etc.,” Farooq said. “It can occur in day-to-day life and no one is immune to sustaining a concussion. Therefore, prevention is very important, but recovery is equally as important.”

According to Farooq, incessant headaches, mood swings, memory problems and struggles with concentrating and schoolwork are all signs that a child has not completely recovered from their concussion. Patients who continue to experience these problems after the initial concussion-triggering event should be seen by a concussion specialist.

In addition, lifestyle changes, such as proper nutrition, drinking plenty of fluids and obtaining sufficient sleep, may also be appropriate for post-concussion management, he said.