The Juvenile Head Trauma Syndrome: A Trauma Triggered Migraine?

Abstract

Background The underlying mechanism of the juvenile head trauma syndrome (JHTS) is still uncertain, but it has been suggested that there is a role in cortical spreading depression, a phenomenon that is assumed to be a part of the pathophysiology of migraine.

Hypothesis We postulate that children affected by the JHTS are more susceptible to cortical spreading depression, caused by a genetic etiology similar to genetic factors in migraine.

Methods Children with the JHTS were selected and evaluated retrospectively in an observational case–control study in two Dutch trauma centers in the period between January 2008 and July 2012.

Results We included 33 patients with the JHTS, who were accounted for approximately 2.5% of the total number (1,342) of children seen at the emergency department with a mild head trauma. The prevalence of migraine in cases compared with controls did not differ. The proportion of patients with a first-degree relative with migraine was significantly higher in cases compared with controls (odds ratio, 2.69; 95% confidence interval, 1.16–6.22; p = 0.010).

Conclusion The JHTS is a relatively rare phenomenon, seen in approximately 2.5% of all children seen at the emergency department with mild brain injury. This study demonstrates a significant relationship between the JHTS and a positive history of migraine in first-degree relatives.

Keywords

juvenile head trauma syndrome - migraine - cortical spreading depression

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