Relationship Between Postconcussion Headache and Neuropsychological Test Performance in High School Athletes

• Published in: The American journal of sports medicine 2003-03, Vol.31 (2), p.168-173
• Main Authors: Collins, Michael W., Field, Melvin, Lovell, Mark R., Iverson, Grant, Johnston, Karen M., Maroon, Joseph, Fu, Freddie H.
• Format: Article
• Language: English
• Subjects: Adolescent; Amnesia, Retrograde - etiology; Amnesia, Retrograde - physiopathology; Athletes; Athletic Injuries - complications; Athletic Injuries - physiopathology; Biological and medical sciences; Brain; Brain Concussion - complications; Brain Concussion - physiopathology; Chi-Square Distribution; Cognition disorders; Cognition Disorders - diagnosis; Cognition Disorders - physiopathology; Cognitive disorders; Cohort Studies; Concussion; Demographic aspects; Female; Football players; Head injuries; Headache; Headache - etiology; Headache - physiopathology; High school students; Humans; Injuries; Injuries of the nervous system and the skull. Diseases due to physical agents; Male; Medical sciences; Memory Disorders - diagnosis; Memory Disorders - physiopathology; Neuropsychological Tests; Odds Ratio; Post-concussion syndrome; Prospective Studies; Reaction Time - physiology; Secondary school students; Sports injuries; Sports medicine; Sports Medicine - methods; Task Performance and Analysis; Time Factors; Traumas. Diseases due to physical agents
• ISSN: 0363-5465; 1552-3365
• DOI: 10.1177/03635465030310020301

Background: The relevance of headache to outcome after sports-related concussion is poorly understood. Hypotheses: High school athletes reporting headache approximately 1 week after injury will have significantly more other concussion symptoms and will perform more poorly on neuropsychological tests than athletes not experiencing headache. Study Design: Prospective cohort study. Methods: Study participants included 109 high school athletes who had sustained concussion and who were divided into two groups: those reporting headache 7 days after injury and those reporting no headaches. The two groups were compared regarding on-field markers of concussion severity at the time of injury and symptoms and neurocognitive test results collected via ImPACT, a computerized neuropsychological test battery and postconcussion symptom scale, at a mean of 6.8 days after injury. Results: Athletes reporting posttraumatic headache demonstrated significantly worse performance on reaction time and memory ImPACT neurocognitive composite scores. These athletes also reported significantly more symptoms other than headache and were more likely to have demonstrated on-field anterograde amnesia. Conclusions: Findings suggest that any degree of postconcussion headache in high school athletes 7 days after injury is likely associated with an incomplete recovery after concussion.