Headache After Pediatric Traumatic Brain Injury: A Cohort Study
Headache After Pediatric Traumatic Brain Injury: A Cohort Study
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DOI：
10.1542/peds.2011-1742
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发表时间：
2012-01-01
期刊：
影响因子：
8
通讯作者：
Rivara, Frederick P.
中科院分区：
文献类型：
--
作者：
Blume, Heidi K.;Vavilala, Monica S.;Rivara, Frederick P.
目的：确定儿童创伤性脑损伤 (TBI) 后 3 个月和 12 个月的头痛患病率。 方法：这是一项针对 5 至 17 岁儿童的前瞻性队列研究，其中我们分析了与手臂受伤对照 (AI；n = 122) 相比，轻度 TBI (mTBI；n = 402) 和中/重度 TBI (n = 60) 后 3 个月和 12 个月头痛的患病率。 结果：总体而言，mTBI 后 3 个月的头痛患病率显着高于 AI 后（43% vs 26%，相对风险 [RR]：1.7 [95% 置信区间 (CI)：1.2-2.3]）、青少年（13-17 岁；46% vs 25%，RR：1.8 [95% CI：1.1-3.1]）和女孩（59% vs 24%，RR：2.4 [95% CI：1.4-4.2]）。年幼儿童中度/重度 TBI 后 3 个月时头痛的患病率也高于 AI（5-12 岁；60% vs 27%；RR：2.0 [95% CI：1.2-3.4]）。受伤后 12 个月，TBI 与头痛频率显着增加无关。然而，患有 mTBI 的女孩比对照组更频繁地报告严重头痛（>= 10 种疼痛量表评分中的 5 种）（27% vs 10%，RR：2.2 [95% CI：0.9-5.6]）。结论：小儿 TBI 与头痛相关。许多儿童在头部受伤几个月后就会出现头痛。受伤后一年内头痛的患病率与受伤严重程度、受伤后时间、年龄和性别有关。女孩和青少年在创伤性脑损伤后的几个月内出现头痛的风险似乎最高。儿科2012; 129：e31-e39
OBJECTIVE: To determine the prevalence of headache 3 and 12 months after pediatric traumatic brain injury (TBI).METHODS: This is a prospective cohort study of children ages 5 to 17 years in which we analyzed the prevalence of headache 3 and 12 months after mild TBI (mTBI; n = 402) and moderate/severe TBI (n = 60) compared with controls with arm injury (AI; n = 122).RESULTS: The prevalence of headache 3 months after injury was significantly higher after mTBI than after AI overall (43% vs 26%, relative risk [RR]: 1.7 [95% confidence interval (CI): 1.2-2.3]), in adolescents (13-17 years; 46% vs 25%, RR: 1.8 [95% CI: 1.1-3.1]), and in girls (59% vs 24%, RR: 2.4 [95% CI: 1.4-4.2]). The prevalence of headache at 3 months was also higher after moderate/severe TBI than AI in younger children (5-12 years; 60% vs 27%; RR: 2.0 [95% CI: 1.2-3.4]). Twelve months after injury, TBI was not associated with a significantly increased frequency of headache. However, girls with mTBI reported serious headache (>= 5 of 10 pain scale rating) more often than controls (27% vs 10%, RR: 2.2 [95% CI: 0.9-5.6]).CONCLUSIONS: Pediatric TBI is associated with headache. A substantial number of children suffer from headaches months after their head injury. The prevalence of headache during the year after injury is related to injury severity, time after injury, age, and gender. Girls and adolescents appear to be at highest risk of headache in the months after TBI. Pediatrics 2012; 129: e31-e39