Sports concussion headache.

BACKGROUND: Sports concussion headache (SCH) is common; yet poorly researched and understood. Somatic complaints including headache are frequently reported by both amateur and professional athletes. Although the literature is replete with reports of a high incidence of headache following sports concussive injuries, there is a dearth of evidence-based medicine to provide practitioners with an understanding of sports concussion headache risk factors, epidemiology, biomechanical risk factors and/or injury thresholds, aetiology, assessment, treatment or prognosis. REVIEW: This article will provide readers with an overview of SCH based on the available literature (which as noted is limited); and, where evidence is lacking, information will be provided from the more general post-traumatic headache (PTHA) literature, the author's extensive clinical experience and literature from parallel primary headache disorders. Incidence, pathoanatomy, neurobiology, classification, natural history and prognosis of sports concussion headache will be reviewed. Common, as well as less common, sports concussion headache sub-types will be discussed. General approaches to evaluation (including history taking and physical examination), as well as treatment approaches will also be addressed for specific headache subtypes. Lastly, directions for future research will be explored.