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Dexamethasone for Post Traumatic Headache

Phase 4
Completed
Conditions
Post-Traumatic Headache
Interventions
Registration Number
NCT04799015
Lead Sponsor
Montefiore Medical Center
Brief Summary

This is a randomized study of intravenous metoclopramide + intravenous dexamethasone versus intravenous metoclopramide for patients with acute post-traumatic headache.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
162
Inclusion Criteria

Meet International Classification of Headache Disorders criteria for acute post-traumatic headache as follows:

  • Traumatic injury to the head has occurred
  • Headache has developed within 7 days of injury to the head
  • Headache is not better accounted for by another diagnosis (e.g., migraine or tension-type headache)
  • The headache must be rated as moderate or severe in intensity at the time of initial evaluation
Exclusion Criteria
  • More than ten days have elapsed since the head trauma
  • Headache has already been treated with an anti-dopaminergic medication
  • Medication allergies
  • Contra-indications including pheochromocytoma, seizure disorder, Parkinson's disease, use of MAO inhibitors, and use of anti-rejection transplant medications

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboMetoclopramide 10mgPlacebo IV + metoclopramide 10mg IV
DexamethasoneMetoclopramide 10mgDexamethasone 10mg IV + metoclopramide 10mg IV
DexamethasoneDexamethasoneDexamethasone 10mg IV + metoclopramide 10mg IV
Primary Outcome Measures
NameTimeMethod
Frequency Moderate or Severe headache after Emergency Department (ED) dischargeUp to 48 hours after ED discharge

Headache intensity will be rated based on the International Headache Society (IHS) 4-point scale. Using this scale participants will verbalize whether their headache intensity is "severe," "moderate," "mild," or "none." The percentage of patients reporting a headache intensity level of either "moderate" or 'severe" will be summarized by study arm. Between-group difference along with 95% confidence intervals will be reported. Patients who use an analgesic or abortive headache medication during the 48 hour period will be considered an outcome failure and their results will not be included in the analysis.

Secondary Outcome Measures
NameTimeMethod
Sustained headache relief48 hours after ED discharge

Sustained headache relief will be defined as the number of patients achieving a headache intensity of "mild" or "none" and who maintain that level for 48 hours after ED discharge without the use of rescue medication. The percentage of patients reporting both headache intensity level of either "moderate" or 'severe" will be summarized by study arm.

Post concussive symptoms7 days after ED discharge

Post concussive symptoms at 7 days will be assessed using the Sport Concussion Assessment Tool (SCAT) Post Concussion Symptom Scale (PCSS). Using the validated SCAT PCSS patients rate the severity of 22 concussive symptoms on a 7-point Likert scale ranging from 0 ("none") to 6 ("severe") yielding an overall possible scoring range of 0-132. Higher SCAT PCSS scores are indicative of more severe level of post-concussive symptoms. Results will be summarized by study arm using basic descriptive statistics.

Use of Rescue medicationDuration of ED admission, up to 3-4 days

Use of rescue medication will be defined as the number of patients administered any analgesic medication or headache abortive medication while in the ED. The number of patients using rescue medication will be summarized by study arm.

Trial Locations

Locations (1)

Montefiore

🇺🇸

Bronx, New York, United States

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