We must increase public awareness of concussions and how they are treated. — Dr. Vincent Schaller, M.D. DABFM, CIC, Director of MAC Alliance

Do Migraines Affect Concussions?

Migraines: Could Having a History of Them Affect Concussion Severity and Recovery?

Dealing with regular, excruciating migraines is tough enough. When someone experiences a concussions, however an extra layer of concern arises in regards to migraines. A 2020 study from the Toronto Rehabilitation Institute shows that concussion patients with a history of migraines are more likely to experience more severe and longer concussion-related symptoms.

Highlights of this longitudinal (one conducted over a period of time) study, as reported in MedPage Today, a clinical source for health care professionals, indicate that:

  • Concussion patients with a pre-injury, lifetime history of migraines exhibited significantly more concussion symptoms than those patients without a history
  • Concussion severity scores were higher among those patients who experienced pre-injury migraines more than once a month
  • Concussion symptoms for those patients who experienced more than one migraine a month remained elevated through the 16-week study
  • 42% of the studied group of 302 concussion patients in week #1 with more than monthly pre-concussion migraines reported continuous post-traumatic headaches as compared to 16% of other patients

Migraines and Concussion History

While this is one of the few studies that link symptomatic recovery to pre-injury baselines, the relationship between migraine history and concussions has been examined for many years. A 2017 report in the Clinical Journal of Sport Medicine  investigated the association between migraines and concussions in athletes. It concluded that a history of migraines could be a modifying factor when caring for concussed athletes.

Migraines, Concussions and Kids

A recent cohort study by Canadian researchers published in JAMA Network Open reported that children who experienced migraines three months after a concussion were more likely to suffer prolonged persistent post-concussive symptoms (PPCS) than similarly concussed patients with other forms of headaches, or with no headaches. This is eye-opening when you consider that, according to Medscape, roughly 840,000 children visit an emergency department each year after having a traumatic brain injury (TBI)—and as many as 90% of those visits involve a concussion. And approximately one third continue to report symptoms a month after the event.

More About Migraines

According to the American Migraine Foundation, 90% of individuals experience post-traumatic headaches after a traumatic brain injury. Risk factors, such as having pre-existing migraines and a family history of them, or simply being female, can make an individual more susceptible to these headaches.

Migraines, which incidentally usually run in families, are chronic conditions which are usually associated with other symptoms such as nausea, dizziness, and sensitivity to light or sound. Throbbing pains on one side of the head or even flashing lights can indicate the onset of the migraine headache.

Why It’s so Important

These studies help illustrate how critical it is for patients to relay full health histories to their healthcare provider when being assessed for head injuries. If we know patients are predisposed for certain conditions, we will take this into consideration when devising treatment plans and considering short-term lifestyle modifications.

In a nutshell: If you’re a regular migraine sufferer, be sure to discuss this (or any other seemingly unrelated health concerns) with your concussion specialist!


[POST UPDATED 06/28/23]

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DR. SCHALLER DISCUSSES CONCUSSION CARE ON ESPN


Dr. Vincent Schaller joins OTL to give his feedback on how we are not properly caring for concussions long term.

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