Majority of Patients Endorsing Post Traumatic Migraine Headaches Features Are Females (P3.332)

Objective: Classify posttraumatic headaches according to International Headache Society criteria and determine relationship between gender, type of headache and severity and duration of post concussion presentation Background: Posttraumatic headaches are not formally classified according to their features. Understanding the characteristics of posttraumatic headaches maybe helpful in determining prognosis and eventually treatment. Methods: As part of our concussion neurology clinics flow, we used Standardized Clinical Assessment and Management Plan. We followed concussion patients, ages 6-21, prospectively and classified their headaches based on HIS definitions. Findings: 569 patients were enrolled. We focused on 242/569 patients who continued to endorse headaches 30 days after onset on concussion. 88.4[percnt] were >10 years of age. Average PCSS was 43.1 at presentation to clinic. 30.8[percnt] had one or more previous concussions. 24.4[percnt] endorsed LOC. 56.5[percnt] endorsed migraine symptoms and out of those who endorsed migraine symptoms 76[percnt] were females. 32.7[percnt] endorsed premorbid headaches and or migraines. 29[percnt] endorsed premorbid learning or cognitive disability. Patients with persistent headaches endorsed significantly more emotional and cognitive symptoms. 68.6[percnt] of patients endorsing headache symptoms after 30 days of concussion onset were females. Females were significantly more likely to endorse more severe overall headache symptoms and more cognitive and emotional symptoms. Mechanism of concussion did not predict severity or nature of symptoms. Conclusions: Patients who present to the outpatient neurology concussion clinic and continue to endorse symptoms beyond 30 days are very likely to endorse severe and frequent headaches that can be classified into migraines. Those who endorse migraine headaches are highly likely to be females. A neurology concussion clinic should be equipped to handle patients with more severe symptoms who are more likely to endorse academic and emotional difficulties. Migraine management expertise would also be needed. Disclosure: Dr. Hawash has nothing to disclose.