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Is migraine a risk factor for the development of concussion?
  1. K E Gordon,
  2. J M Dooley,
  3. E P Wood
  1. IWK Health Centre, Dalhousie University, Halifax, Nova Scotia B3K 6R8, Canada
  1. Correspondence to:
 Dr Gordon
 kegor{at}dal.ca

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Concussion, which is defined as “a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces”,1,2 is a poorly characterised clinical syndrome. Prospectively validated features include loss of consciousness, amnesia, headache, blurred vision, dizziness, nausea, and attention deficit,3 although none of these phenomena is mandatory. There has been a recent increase in both awareness of and interest in sports related concussion.1,2,4,5

Trauma has also been associated with migraine. Matthews6 identified footballer’s migraine in which soccer players suffered migraine headaches after heading the ball. Typically the head injury was minor and was not associated with loss of consciousness, although confusion and impaired consciousness was more likely to be reported in children.7,8

The congruence of symptoms in migraine and concussion may lead to confusion in diagnosing the adolescent who has suffered a head injury, reportedly leading to a possible over-diagnosis of concussion and under-recognition of trauma induced migraine.9 The overlap between migraine and concussion may also reflect an increased propensity in migraineurs for concussion.

This study was designed as an exploratory analysis to investigate an observed clinical association between migraine and concussion.

Methods

The Canadian Community Health Survey is a cross sectional survey that collects information on health status, healthcare utilisation, and health determinants for the Canadian population. A stratified cluster sample design is used to obtain information on Canadians aged 12 years or older living in private dwellings in the 10 provinces and the three territories, exclusive of persons living on First Nations Reserves or Crown Lands, residents of institutions, full time members of the Canadian Armed Forces, and residents of certain remote regions. Information is collected every two years.10,11

Our analysis was based on the public use microdata set of the Canadian Community Health Survey, Cycle 1.1 …

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