The prevalence of primary headache disorders in the general population provides a unique challenge in the evaluation of headache occurring in the context of sport. Despite a wealth of studies exploring the epidemiology of headache in the layperson, little is known about the prevalence and nature of headaches in collegiate student-athletes. These scenarios are challenging in the return to play context, as it is often unclear whether an athlete has an exacerbation of a primary headache disorder, new onset headache unrelated to trauma, or has suffered a concussive injury.To establish the prevalence and nature of headaches in collegiate student-athletes.Retrospective cross-sectional survey.This cross-sectional survey evaluated the characteristics and prevalence of headache in 834 student-athletes from four NCAA Division-I institutions. Because headache occurrence may vary by sport (collision, contact, non-contact), by sex, and medical history, our sample included male and female athletes in a variety of sports, with differing degrees of contact exposure. The 20 question survey collected data on personal and family history of headache, as well as concussion history.A total of 23.7% (n?=?198) of participants reported having a personal history of migraine, 25.2% (n?=?210) history of sinus headache, and 12.3% (n?=?103) history of tension type headache. Among athletes with a prior history of concussion, 46.3% (n?=?25) of females reported a history of migraine, while only 32.2% of males reported history of migraine (?2 ?=?3.421, P?=?.064).The etiology of increased prevalence of migraine in our study is unclear. Whether this is due to increased awareness of headache disorders, a consequence of contact exposure, or a predisposition for migraine development in this age group remains unclear. Further studies are indicated.
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