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CINCINNATI – Intravenous migraine therapy reduces post-traumatic headache (PTH) scores for children presenting to the emergency department within 14 days after suffering a mild traumatic brain injury (mTBI), according to a new study.
Whether the treatment has long-term benefits, however, is yet to be determined, according to the research printed recently in the American Journal of Emergency Medicine.
Background in the article notes that more than 3.8 million children sustain brain injuries annually, but that treatment of PTH in the ED varies and the benefits have been unclear.
To clarify the issue, researchers from the Cincinnati Children's Hospital Medical Center sought to determine if intravenous migraine therapy reduces pain scores in children with PTH as well as other factors associated with improved response.
For the retrospective study, the researchers looked at children, 8 to 21 years old, who presented to a tertiary pediatric ED with mTBI and PTH from November 2009 to June 2013. Included in the study were children who had an mTBI defined by diagnosis code within 14 days of the ED visit, headache, and administration of one or more intravenous medications: ketorolac, prochlorperazine, metoclopramide, chlorpromazine, and ondansetron.
With the primary outcome defined as a pain score reduction greater or equal to 50% during the ED visit, the researchers also analyzed potential predictors of treatment success, including age, sex, migraine or mTBI history, time since injury, ED head computed tomographic (CT) imaging, and pretreatment with oral analgesics.
The 254 patients included in the study had a mean age of 13.8 years and were 51% female and 80% white. Mean time since injury was two days, and 114 of the patients had negative head CTs.
Results indicate that 86% of patients had treatment success with intravenous migraine therapy; 52% experienced complete resolution of headache. Patients who had a head CT were less likely to respond – 80% vs 91%.
“Intravenous migraine therapy reduces PTH pain scores for children presenting within 14 days after mTBI,” the authors conclude. “Further prospective work is needed to determine long-term benefits of acute PTH treatment in the ED.”