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Abstract Details

Effects of Pre-Accident History of Migraine on Acute Concussion Symptoms and Recovery: The Toronto Concussion Study
Neuro Trauma, Critical Care, and Sports Neurology
P10 - Poster Session 10 (5:30 PM-6:30 PM)
5-008
To characterize concussion symptoms and recovery trajectory in adults in the general population with a concussion and a history of migraine.  
History of migraine has been identified as a potential risk factor for persisting post-concussion symptoms (PCS) in studies in selected populations; however, the literature on migraine as a PCS risk factor in the general adult population is limited.

A prospective cohort analysis of adults diagnosed with concussion in referring Emergency Departments and assessed at a concussion clinic within one-week post-injury.  Accidents were not claim-related (i.e. not workplace or motor vehicle collision related). SCAT 3, headache questionnaires, and biweekly physician assessments were administered Weeks 1 – 8 and weeks 12 and 16 post-injury.

302 adults (59% female), mean age of 33.6 years (13.0 SD), were in this analysis; 116 (38%) had a pre-accident history of migraine, 49% of females and 23% of males, and 84% had active migraine pre-injury. Individuals with pre-accident migraine history had significantly higher (p=0.007) SCAT 3 scores than those without migraine in the acute phase (is the p=0.007) and through week 16 (p=0.002). Pre-accident migraine history did not increase likelihood of post-traumatic headache (PTH) in the acute phase; however, it was related to a 2.79 times risk (95%CI 1.37 – 5.68, p=0.005) at Week 12 and 2.57 times risk (95%CI 1.13 – 5.83, p=0.025) at Week 16 of experiencing headaches above pre-accident baseline headache frequency. Individuals with a pre-accident history of migraine were also 4.32 (95%CI 1.75 – 10.68, p=0.0015) times more likely to not be deemed “recovered” by physician at Week 8. 

Adults with pre-accident history of migraine have more acute, severe, and prolonged concussion symptoms. A pre-accident history of migraine predicts risk for continuing PTH above pre-accident headache frequency at 12 and 16 weeks post-concussion and delayed overall recovery at 8 weeks post-injury.  
Authors/Disclosures

PRESENTER 		No disclosure on file
No disclosure on file
David Lawrence, DO No disclosure on file
Paul Comper, PhD, CPsych No disclosure on file
No disclosure on file
No disclosure on file
Jonathan P. Gladstone, MD Dr. Gladstone has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lily. Dr. Gladstone has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Gladstone has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Allergan. Dr. Gladstone has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lily. Dr. Gladstone has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Gladstone has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Teva. Dr. Gladstone has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan. Dr. Gladstone has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Aralez. Dr. Gladstone has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Gladstone has received publishing royalties from a publication relating to health care.