ClinicalTrials.gg
RecruitingNCT04685772Updated Aug 26, 2026

Assessment of the Efficacy of Medrol Dose Pack for Acute Post-Concussive Headaches

An observational study in Post-Concussion Syndrome and Headache, sponsored by Northwell Health. Recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-08-26.

Sponsored by Northwell Health · Observational

From the registry’s dates

  • Started Apr 2021; still recruiting 5 years 7 months later.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
25
Ages
18 Years and older
Sex
All
01

Study summary

This novel pilot project will assess the effectiveness of corticosteroids in treatment of acute post-concussion headache. The investigators hypothesize that the use of corticosteroids will cause significant headache reduction in frequency and/or intensity than individuals who undergo the current standard of care. Additionally, the investigators hypothesize that corticosteroid use will lead to a reduction in other somatic symptoms including vestibular symptoms, leading to quicker return to school, work, and/or ability to play sports.

Read the detailed description

To the best of the investigators' knowledge, this is a novel study. Studies have been previously done on individuals who have suffered an acute TBI and were admitted to an intensive care unit (ICU) setting but none have been completed on individuals who suffer post-concussion headaches. Despite a high prevalence of post-concussive headache, there are no evidence-based guidelines for acute or preventive pharmacological treatment. Patients who experience very frequent or daily headache post-concussive headache are also at risk of developing medication-overuse headache (MOH)12. In addition, patients with post-concussive headache experience disabling comorbidities such as symptoms of depression, anxiety, and sleep disturbances 12 This study will be of benefit to patients who suffer headaches after a concussion because, though various treatments have been studied, including a combination of Reglan and Benadryl (63% effective in one prospective study) triptans vs non-triptans (70% effective vs 42% effective in one retrospective trial), gabapentin vs tricyclic antidepressants vs. no medication (no significant difference in outcome), none have been established as a definitive treatment regimen for post-concussive headache 12. Corticosteroids are currently utilized for management of these headaches; they are done so at the discretion of the physician and like the aforementioned medications, are not standard of care. Corticosteroid used in severe TBI (GCS \< 8) have been widely studied8, however the utility has not been conclusive. Of note, case studies in the pediatric population with mild TBI (GCS 13-15) and post-concussive headache, report that they respond well to the Medrol Dose Pack with headache improvement during or after completion of the medication2. Currently, there is no standard treatment of post-concussion headaches, and in clinical practice, it has been observed that only approximately 50% of patients improve without any medication use. It is important to establish the role of corticosteroids in treating post-concussive headaches because they may improve quality of life and accelerate patient's functional recovery.

02

Conditions studied

  • Post-Concussion Syndrome
  • Headache

Keywords

  • Methylprednisolone
  • Medrol Dose Pack
  • Steroid
03

In context

Post-Concussion Syndrome

141 studies on the registry are indexed under Post-Concussion Syndrome; 34 are open to participants now.

This study's planned enrollment of 25 is below the median of 90 across 20 observational studies indexed under Post-Concussion Syndrome.

Browse Post-Concussion Syndrome studies →

Lead sponsor

Northwell Health is the lead sponsor of 475 studies on the registry; 107 are open to participants now.

Of its 45 completed or terminated interventional studies of FDA-regulated products, 23 (51%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Sampling method
Non-probability sample

Study population

Patients who meet the inclusion criteria will be consented for the study. Patients will be recruited when they follow up on their initial appointment after hospitalization

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Provision of signed and dated form (in person or via telehealth)
  2. Stated willingness to comply with all study procedures and availability for the duration of the study
  3. Male or female, aged >18 years old
  4. Ability to take oral medication and be willing to adhere to the study regimen as described in this protocol
  5. Patients presenting with all types of post-concussive headache with >5/10 in severity on the numerical analog scale.
  6. Headache that occurs for > 4 hours per day
  7. Headache that occurs every day
  8. Headache that began after concussion, patient was diagnosed at an outpatient clinic or was hospitalized
  9. Headache developed within 7 days post-injury and patient presenting within 30 days from initial trauma
  10. A diagnosis of concussion.
  11. If a patient is taking another pain medication, this still be included in the stud

Exclusion criteria

Exclusion Criteria:

  1. Any evidence of known intracranial hemorrhage on neuroimaging
  2. Headache developing after 7 days post injury and patient presenting after 30 days from initial trauma
  3. Headache occurs \< 4 hours per day
  4. Headache does not occur daily
  5. Age \< or = 18
  6. Headache is \< 5 in severity on numerical analog scale
  7. Presence of increase in intracranial pressure or papilledema
  8. Any to
  9. Allergy or sensitivity to corticosteroids
  10. Active Tuberculosis
  11. Active pregnancy
  12. Currently on corticosteroids for another reason
  13. Participants with fungal infection
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
25 participants (estimated)
Target follow-up
3 Months
Patient registry
Yes

Interventions

  • The Methylprednisolone dose pack (Medrol Dose Pack) is pre-packaged with dosing instructions. This dose pack is tapered over 7 days and administration will be the following for all patients: Day 1 (total 24 milligrams (mg)) - 8mg before breakfast, 4mg after lunch and dinner, and 8mg at bedtime Day 2 (total 20mg) - 4mg before breakfast, after lunch and dinner, and 8mg at bedtime Day 3 (total 16mg) - 4mg before breakfast, lunch, dinner, and at bedtime Day 4 (total 12mg) - 4mg before breakfast, after lunch, and at bedtime Day 5 (total 8mg) - 4mg before breakfast and at bedtime Day 6 (total 4mg) - 4mg before breakfast Day 7 (total 0mg) - Completed

    Also known as: No methylprednisolone

06

What researchers measure

Primary outcomes

  1. Change in headaches

    Defined as change in headache in response to medication

    Time frame: 1 Week

Secondary outcomes

  1. Change in total Post Concussion Symptom (0-120) scores over time

    change in the NEW total PCSS score from baseline (day0) to week 1, to week 4 and to week 12; Higher scores indicate worse symptoms.

    Time frame: 12 weeks

  2. EQ-5D (Euro Qual Health State Questionnaire) score changes (1-100 in each category); higher score indicates better state of health in several domains.

    EQ-5D score in the categories of 'Usual Activities' and 'Pain/Discomfort' of the EQ-5D Health Questionnaire between visit 1 (day 7) and visit 5(week 11/12)

    Time frame: 12 weeks

  3. Diary of other medication use and pain level

    Secondary outcome 9: Each patient will be asked to keep a daily diary, recording pain medications used and a pain level (in a scale of 0-10).

    Time frame: 12 weeks

07

Study locations

1 of 1 sites recruiting
  • Northwell Health - North Shore University Hospital
    Manhasset, New York 11030, United States
    Recruiting
    • Jamie Ullman, MD · Contactjullman1@northwell.edu · 516-562-4300
    • Betsy Moclair, RN, CCRC · Contactbmoclair@northwell.edu · (516) 253-7753
    • Dana Klavansky, MD · Sub investigator
    • Robert Duarte, MD · Sub investigator
    • Rosanna Sabini, MD · Sub investigator
    • Luca Giliberto, MD · Sub investigator
08

References and documents

Publications

  • Bulamu NB, Kaambwa B, Ratcliffe J. A systematic review of instruments for measuring outcomes in economic evaluation within aged care. Health Qual Life Outcomes. 2015 Nov 9;13:179. doi: 10.1186/s12955-015-0372-8. PubMed 26553129 ↗
  • Bramley H, Hong J, Zacko C, Royer C, Silvis M. Mild Traumatic Brain Injury and Post-concussion Syndrome: Treatment and Related Sequela for Persistent Symptomatic Disease. Sports Med Arthrosc Rev. 2016 Sep;24(3):123-9. doi: 10.1097/JSA.0000000000000111. PubMed 27482778 ↗
  • Bramley H, Melinosky C, Silvis M, Ross S. Pediatric posttraumatic headache: two cases using steroids as abortive therapy. Pediatr Emerg Care. 2012 Oct;28(10):1081-4. doi: 10.1097/PEC.0b013e31826ceeeb. PubMed 23034499 ↗
  • Cushman DM, Borowski L, Hansen C, Hendrick J, Bushman T, Teramoto M. Gabapentin and Tricyclics in the Treatment of Post-Concussive Headache, a Retrospective Cohort Study. Headache. 2019 Mar;59(3):371-382. doi: 10.1111/head.13451. Epub 2018 Nov 19. PubMed 30451286 ↗
  • Ducic I, Sinkin JC, Crutchfield KE. Interdisciplinary treatment of post-concussion and post-traumatic headaches. Microsurgery. 2015 Nov;35(8):603-7. doi: 10.1002/micr.22503. Epub 2015 Sep 26. PubMed 26409037 ↗
  • EuroQol Group. EuroQol--a new facility for the measurement of health-related quality of life. Health Policy. 1990 Dec;16(3):199-208. doi: 10.1016/0168-8510(90)90421-9. PubMed 10109801 ↗
  • Halstead ME. Pharmacologic Therapies for Pediatric Concussions. Sports Health. 2016 Jan-Feb;8(1):50-2. doi: 10.1177/1941738115622158. PubMed 26660460 ↗
  • Hoshide R, Cheung V, Marshall L, Kasper E, Chen CC. Do corticosteroids play a role in the management of traumatic brain injury? Surg Neurol Int. 2016 Sep 13;7:84. doi: 10.4103/2152-7806.190439. eCollection 2016. PubMed 27656315 ↗
  • Kacperski J. Pharmacotherapy for Persistent Posttraumatic Headaches in Children and Adolescents: A Brief Review of the Literature. Paediatr Drugs. 2018 Oct;20(5):385-393. doi: 10.1007/s40272-018-0299-8. PubMed 29876872 ↗
  • King NS, Crawford S, Wenden FJ, Moss NE, Wade DT. The Rivermead Post Concussion Symptoms Questionnaire: a measure of symptoms commonly experienced after head injury and its reliability. J Neurol. 1995 Sep;242(9):587-92. doi: 10.1007/BF00868811. PubMed 8551320 ↗
  • Kuczynski A, Crawford S, Bodell L, Dewey D, Barlow KM. Characteristics of post-traumatic headaches in children following mild traumatic brain injury and their response to treatment: a prospective cohort. Dev Med Child Neurol. 2013 Jul;55(7):636-41. doi: 10.1111/dmcn.12152. Epub 2013 Apr 5. PubMed 23560811 ↗
  • Larsen EL, Ashina H, Iljazi A, Al-Khazali HM, Seem K, Ashina M, Ashina S, Schytz HW. Acute and preventive pharmacological treatment of post-traumatic headache: a systematic review. J Headache Pain. 2019 Oct 21;20(1):98. doi: 10.1186/s10194-019-1051-7. PubMed 31638888 ↗
  • Marshall S, Bayley M, McCullagh S, Velikonja D, Berrigan L, Ouchterlony D, Weegar K; mTBI Expert Consensus Group. Updated clinical practice guidelines for concussion/mild traumatic brain injury and persistent symptoms. Brain Inj. 2015;29(6):688-700. doi: 10.3109/02699052.2015.1004755. Epub 2015 Apr 14. PubMed 25871303 ↗
  • Potter S, Leigh E, Wade D, Fleminger S. The Rivermead Post Concussion Symptoms Questionnaire: a confirmatory factor analysis. J Neurol. 2006 Dec;253(12):1603-14. doi: 10.1007/s00415-006-0275-z. Epub 2006 Oct 24. PubMed 17063314 ↗
  • Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001 Jul;33(5):337-43. doi: 10.3109/07853890109002087. PubMed 11491192 ↗
  • Seifert T. Post-Traumatic Headache Therapy in the Athlete. Curr Pain Headache Rep. 2016 Jun;20(6):41. doi: 10.1007/s11916-016-0568-6. PubMed 27184059 ↗
  • Solomon S. Post-traumatic headache: commentary: an overview. Headache. 2009 Jul;49(7):1112-5. doi: 10.1111/j.1526-4610.2009.01462.x. PubMed 19583600 ↗
  • Bland JM, Altman DG. Applying the right statistics: analyses of measurement studies. Ultrasound Obstet Gynecol. 2003 Jul;22(1):85-93. doi: 10.1002/uog.122. PubMed 12858311 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 26, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04685772
Lead sponsor
Northwell Health
Responsible party
Sponsor
First posted
Dec 28, 2020
Start date
Apr 1, 2021
Primary completion
Dec 1, 2027 (estimated)
Completion
Dec 1, 2027 (estimated)
Last update
Aug 26, 2026

Study contacts

Jamie Ullman, MD
Contact
Jullman1@northwell.edu
(516) 562 4300
Betsy Moclair, RN, CCRC
Contact
bmoclair@northwell.edu
(516) 253-7753
Jamie S Ullman, MD
principal investigator · Hofstra Northwell School of Medicine

Oversight

FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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