Migraine attacks triggered by mild head trauma, and their relation to certain post-traumatic disorders of childhood.

This paper reports five cases who repeatedly had migraine attacks triggered by mild head trauma. All the cases had some of the various neurological manifestations of migraine as a part of the attacks, and in three cases these manifestations generally occurred without headache. Although there are reports about patients beginning their 'career' in migraine after suffering head trauma (Michael and Williams, 1952; Muller, 1955; Burke and Peters, 1956; Barolin, 1966), there are no reports about patients having individual migraine attacks minutes or hours after a blow to the head. However, Whitty, in his paper 'Migraine without headache' (1967), mentioned the past history of a 50-year-old man (case 6) who 'when an amateur boxer . .. had had attacks of numbness and weakness of the left side lasting one half to one hour and associated with throbbing headaches after fights in which he received punishment to head. They ceased when he gave up boxing'. We believe such cases are more unrecognized than rare, and hope that this report will stimulate more general recognition of their occurrence. If a patient should present at the emergency room with the history of sudden onset of hemiplegia occurring shortly after a blow to the head, how many physicians would consider the diagnosis of migraine? There are a few reports in the literature of blindness and other neurological symptoms and signs occurring in children shortly after mild head trauma (Pickles, 1949; Bodian, 1964; Griffith and Dodge, 1968). The pathogenesis of these episodes has been most uncertain. We see sufficient clinical similarity between these episodes and the post-traumatic episodes in our five migraine patients to suggest a pathogenesis common to both groups. We will present a sixth patient who helps link our migraine cases with the reported post-traumatic childhood cases by sharing symptoms and signs of both entities. CASE REPORTS