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Young athletes' post-concussion migraine may signal greater neurocognitive impairment

PITTSBURGH, June 21 High school and college athletes with migraine headache characteristics after a concussion may have increased neurocognitive impairment, suggests a University of Pittsburgh Sports Medicine Concussion Program study published in the May issue of the Journal of Neurosurgery. The study results speak to the need for extreme caution in clinical evaluation and return-to-play decisions, say the authors.

In the study, athletes who had characteristics of post-traumatic migraine (PTM) headache following a concussion also showed increased neurocognitive function impairment and related symptoms compared to concussed athletes with no post-injury headache or non-migraine headache.

"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), A.T.C., who now is a doctoral student working in the Sports Medicine Research Laboratory at the University of North Carolina at Chapel Hill.

"This research is important because headache is the most common reported symptom after a sports-related head injury. As many as 86 percent of these injuries are accompanied by some type of headache," commented study co-author Joseph Maroon, M.D., professor of neurological surgery at the University of Pittsburgh School of Medicine.

"We are concerned because even though headache may be noted as a symptom in the young athlete with a concussion, he or she may be allowed to return to play before the headache resolves and later may suffer from second-impact syndrome, which, although rare, may be catastrophic," Dr. Maroon stressed.

University of Pittsburgh researchers were the first to study the relevance of headache in the recovery of concussed high school athletes. That study, published in the March/April 2003 issu
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