Concussions are common, but complex, traumatic brain injuries seen in pediatric athletes of all ages & skill levels & occur in a wide variety of athletic settings.  These mild traumatic brain injuries often have neurologic sequelae, including headaches. Although athletes are advised to rest, duration of post-concussive symptoms is often unpredictable.

We aim to identify the potential risk factors associated with increased susceptibility for persistent post-concussive headaches.

We conducted a cross sectional study on patients aged 5-18 years with head injury who presented to pediatric concussion clinic (N= 603) from September 2013 to Dec 2018. We excluded patients with skull fractures and intracranial hemorrhage.

The data was compiled & analyzed using frequency, Pearson correlation test, chi square & ANOVA test using IBM SPSS-26.

Patient cohort consisted of 364 males & 239 females. The age range for males was 5-18 years (Mean±SD = 13.45±2.86) & for females was 6 -18 years (Mean±SD = 13.97±2.84).

There was a statistically significant association between various age groups & presence of headache at 3 month & at 6 months (p<0.05) but there was no significant association beyond 6 months (p>0.05). The age group 5-8 years had the highest risk of persistent headaches while the age group 14-18 years were more likely to have headaches at 3 months with subsequent improvement by one year (p<0.05).

Females were more likely than males (of all ages) to have persistent headaches despite treatment (p= 0.00). There was also statistically significant association of loss of consciousness, prior history of headaches & prior history of concussions with the development of persistent headaches (p<0.05).

Furthermore, football, soccer & basketball players had significantly more headaches compared to other sports related injuries (p =0.001).

There was a statistically significant higher risk of developing persistent headaches for females & those with a history of prior headaches, prior concussions, younger age & those playing football, soccer & basketball.