HCPLive Network

Pain Medication May Worsen Headache After Concussions

Teens who reported chronic headache months after having concussions may have been taking too much pain medication, a new study suggests. Geoffrey Heyer, MD, and Syed Idris, MD, of Nationwide Children’s Hospital in Columbus, OH, presented their findings in a poster presentation at the Child Neurology Society 2013 annual meeting, held in Austin, TX.
 
Approximately half of the adolescents with post-concussion headaches lasting three to 12 months exhibited complete resolution of symptoms or reduction to pre-concussion levels of headache after discontinuing their analgesics. The researchers noted that because withdrawal of pain medication alleviated their headaches, they met a diagnosis of medication overuse headache, according to International Classification of Headache Disorders criteria.
 
The investigators performed a chart review of 104 consecutive adolescent patients treated at Nationwide Children’s Hospital for concussion. Seventy-seven of these reported chronic headache after the injury, and 54 were thought to have “probable” medication overuse headache.
 
Within two months of stopping analgesics, 37 of the 54 patients in the “probable” group had improvement in headache symptoms.
 
The factors significantly associated with probably medication overuse headache included daily headache (P = 0.006), female sex (P = 0.02), presence of nausea (P<0.001), throbbing headache versus steady or stabbing pain (P = 0.001), irritability following concussion (P = 0.03), and a relatively longer interval between the concussive event and neurologic evaluation (P = 0.003).
 
Each of these factors was present in at least 75% of the probable medication overuse group and less than half of the other patients.
 
The researchers noted that continued use of analgesics for headache despite lack of efficacy can cause chronic headache syndrome.



Further Reading
The immune system is the new focus of much work on traumatic brain injury (TBI). In a challenge to the paradigm that the blood brain barrier prevents harmful leukocytes from entering the brain, a Texas team tried to neutralize the impact of these cells. Peripheral lymphocytes are activated after TBI. They may then act as potential antigen presenting cells and get into the brain, causing cells there to degenerate.
Hospital conversion to for-profit status is associated with improvements in financial margins, but has no effect on process quality metrics or mortality rates, according to a study published in the Oct. 22/29 issue of the Journal of the American Medical Association
Increasing use of hospice in the final days of ovarian cancer does not offset intensive end-of-life care in older women, according to a study published online Oct. 6 in the Journal of Clinical Oncology.
Drug coupons could reduce patients' out-of-pocket costs by 60 percent, according to a study published in the October issue of Health Affairs.
Depressive symptoms are associated with poorer long-term outcome in patients undergoing surgery for lumbar spinal stenosis (LSS), according to research published in the Oct. 1 issue of The Spine Journal.
Binge drinking among young adult men may lead to hypertension, according to new research scheduled to be presented at the American Society of Nephrology's Kidney Week 2014, held from Nov. 11 to 16 in Philadelphia.
Tests and diagnostic procedures often help physicians discover conditions or formulate treatments, but researchers say some tests are used far more often than they are worth. Here are 5 tests and procedures physicians should think twice about before prescribing.
More Reading