To present and analyze four cases in young children where migraine onset occurred after subconcussive head impact and to review what is known about the clinical presentation, environmental, and genetic risk of these two diagnoses. 

Patient comparisons are presented in Table 1. All patients were female, premenarche, had a family history of migraine, and presented following a traumatic head injury. Each patient had a history of cyclical vomiting or carsickness. Key mediating factors in patient symptoms included pain relief after vomiting and lessening headaches after menarche. All patients met the criteria for acute migraine per the International Classification of Headache Disorders (ICHD3) criteria. None of the patients met the criteria for diagnosis of concussion based on the 2014 criteria [3] or 2023 consensus[4]  statement on concussion in sport.