Juvenile head trauma syndromes and their relationship to migraine.

The clinical spectrum of juvenile head trauma syndromes was derived from an analysis of 50 attacks in 25 patients. Attacks were grouped into four clinical types: (1) hemiparesis; (2) somnolence, irritability, and vomiting; (3) blindness; and (4) brain stem signs. Our evidence shows that these four types are different manifestations of a common underlying process. All attacks followed mild head trauma after a latent interval, generally of one to ten minutes. Forty of the 50 attacks occurred in patients under 14 years of age. Full recovery occurred after a variable time in all but one instance. This patient, and one other, had an angiographically demonstrable occlusion of a branch of the middle cerebral artery. In clinical and laboratory features, these attacks resemble classical migraine and presumably have a similar underlying mechanism.