Vomiting after mild head injury is related to migraine.

OBJECTIVE

To determine whether vomiting after mild head injury in children is related to migraine and to identify predictors of vomiting after head injury.

METHODS

A series of consecutive children admitted to the observation unit of an emergency department after mild head injury was identified by chart review. A telephone interview with the parents or child or both was then conducted by using a structured questionnaire.

RESULTS

Of 47 eligible children with acute head injury, 44 (94%) were contacted. The mean age at head injury was 7.4 years. Twenty-nine children (66%) vomited after the head injury. The likelihood of vomiting was increased if the child had a history of recurrent headache (p = 0.05). If the headaches were migrainous, the likelihood of vomiting increased further (p <0.002). All 15 children with a history of motion sickness vomited after the head injury. Family history of migraine, particularly maternal (n = 21), also predicted recurrent vomiting (p <0.001). If more than one of these predictive variables was present, the likelihood of vomiting was 100%.

CONCLUSIONS

History of motion sickness, migraine headaches, and family history of migraine are highly predictive of vomiting after a mild head injury.