"It's exactly what's needed": a call to action for breastmilk studies of vertical HIV transmission in high-income countries.

Headache attributed to trauma—post-traumatic headache (PTH)—is a common and debilitating symptom following concussion. There are at least 3 million Americans who sustain a concussion annually. Current concussion diagnostic criteria include acute signs (e.g., loss of consciousness, altered mental status, or amnesia), a constellation of physical, emotional, and cognitive symptoms within 72 hours of injury, and/or objective deficits on physical exam. Guidelines have been developed to support individuals’ gradual return to physical and cognitive activities, however, there is a paucity of high-quality evidence to guide treatment of PTH. Concussion symptoms typically improve over weeks and completely resolve by one month, although a third of patients may develop persisting symptoms after concussion (PSaC), including PTH, which can contribute to negative impacts on quality of life. Effective management of PTH and the need for specialized therapies, including for patients with a preexisting migraine diagnosis, were recently identified as the second highest concussion research priority, based on a national priority-setting exercise of patients, caregivers, and front-line clinicians. The International Headache Society (IHS) defines PTH as a headache that emerges within 7 days of a head injury and is described as persistent PTH when the headache lasts longer than 3 months. Headache may be predictive of the development of PSaC, which is associated with reduced physical and psychosocial health-related quality of life, greater levels of anxiety and depression, and increased risk of mental health decline including self-harm and psychiatric hospitalization. Timely, comprehensive, multidisciplinary care for youth with concussion is essential to optimize recovery to prevent long-term impacts on development, functioning, and quality of life, and facilitate early reintegration to school, sports, and daily activities. There are few high-quality studies supporting pharmacotherapeutic interventions in PTH. Previous studies on PTH management have primarily evaluated acute intravenous therapies—such as antiemetics, antidopaminergic agents, and fluids—which may provide short-term symptomatic relief—as well as oral daily preventive therapies including melatonin, amitriptyline, gabapentin, and other tricyclic antidepressants. However, evidence for consistent or sustained long-term benefit from pharmacotherapies remains limited.