Headaches After Head Injuries — Post-Traumatic Headaches

Seymour Solomon, MD, Headache Unit, Montefiore Medical Center, Albert Einstein College of Medicine
Headaches After Head Injuries — Post-Traumatic Headaches

Headache immediately following a head injury usually clears after minutes or days but sometimes headaches may persist for months or rarely years. The long-term headaches are called post-traumatic or post-concussion headaches.

One can understand why headaches may follow a moderate or severe injury to the brain such as a concussion (bruise) or laceration (tear). What has been more difficult to understand and has presented an ongoing controversy are chronic headaches following mild head injuries.

Mild injuries of the brain are characterized as a concussion (a brief disturbance of brain function causing loss of consciousness or transient difficulty in thought processes).

Because the neurological examination after mild head injury is normal and standard tests as well as imaging studies (such as MRI or CT of the head) similarly fail to reveal abnormalities, many thought that the symptoms following mild head injury were psychological.

But microscopic studies have shown disruption of the nerve fibers in the brain due to the stretching or shearing forces of the trauma. Other subtle changes have been noted in brain functioning.

The clinical features of post traumatic headache may vary from one individual to another. Most headaches would be now classified as chronic tension-type headache. These headaches are typically a steady ache affecting both sides of the head and occurring daily or almost everyday. They are of slight to moderate intensity but intermittently, upon this base of low grade headache bouts of severe or moderately severe headache may occur and these often are similar to, if not identical with migraine (one sided throbbing pain associated with nausea and sensitivity to light and noise).

Unfortunately, people who experience post-traumatic headaches also experience other symptoms of the post-traumatic or post-concussion syndrome. There may be other neurological symptoms such as dizziness, ringing in the ears, vague blurring of vision, psychological symptoms occur such as depression, anxiety, personality change, disturbance in sleep, and impairment libido.

Finally, people with the post-concussion syndrome have changes in their mental functioning, primarily difficulty in concentration, inability to work efficiently and associated difficulty maintaining attention and retaining memory.

The treatment of post-traumatic headache, as well as other features of the post-traumatic syndrome is symptomatic. That is each symptom is treated individually because, unfortunately, there is no medication that will alter the underlying disturbance in the brain.

Most often treatment of the chronic tension-type headache consists of such medications as the tricyclic antidepressants (for example amitriptyline). These agents not only diminish depression but also decrease pain.

The periodic worsening of headaches, if they have characteristics of migraine, are treated with typical migraine medications (for example, sumatriptan for an acute attack).

Non-drug methods of therapy are also advisable. Healthy habits should be encouraged by elimination of nicotine and alcohol, by recommendations for regularity with regard to sleep and meal time and by exercise at least every other day. Relaxation techniques may be helpful. These can be learned by biofeedback techniques as well as by such methods as meditation.

Last but not least is attention to psychological factors. The family, friends, and employer or teacher should be educated so the fact that headaches are not purely psychological but have a basis related to the disturbed structure and chemical functions of the brain. A psychologist may be helpful in teaching pain coping techniques and in treating the psychological symptoms that are part of the post-traumatic syndrome.

Fortunately, most headaches following head injury gradually taper off within the first three to six months. Even those unfortunate individuals who experience symptoms much longer can be helped.

 

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

Posted on BrainLine December 15, 2008. Reviewed August 9, 2018.

About the Author

Dr. Seymour Solomon is a neurologist in Bronx, New York and is affiliated with multiple hospitals in the area, including Burke Rehabilitation Hospital and Montefiore Medical Center. He received his medical degree from Medical College of Wisconsin and has been in practice for more than 20 years. He is one of 41 doctors at Burke Rehabilitation Hospital and one of 78 at Montefiore Medical Center who specialize in Neurology.

From Help for Headaches. www.headache-help.org.

Comments (528)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

I was cleaning my room when the heavy sound box fell on my head, mainly around the occipital bone. At the time, it felt like someone hit me so hard on my head that I couldn't stop screaming and was confused. It happened on 2018 and since then I have been having pain mostly around where I got hit. I used to be very good at remembering where I kept certain things, and I would never forget a thing! However, it all changed since then. I get frustrated so easily because of the constant pain I feel on the back of my head. I cannot stand loud noises now. I think it's been 3 years now, and the pain still bothers me on daily basis and now my neck hurts a lot too. I am planning on visiting a physician in few days. I hope nothing worse is in store for me.

Omg it happened to me also, year 2018 i was a part of cheer leading squad and i fell hitting my head on the floor. Until now im experiencing that pain in the part where my head got hit. Im still good at remebering things tho. I hope we both get healed.

I got pulled over by a dog on a stretchy lead chasing a ball, I went down on my face, top left eyebrow & chin. lumps then bruising which looks awful. 5 days later im still having sharp pain left side of the face with the smallest of moment or vough

I hit the top of my head in January 2019. Here I am, in October 2021 with a headache that started 2 or 3 days after the incident and has been there continually (every waking minute of every day) from that day to this. Medication has only provided slight relief and the UK health service hasn't been helpful otherwise.
That's over 1,000 days of constant headache and I'm sick to my back teeth of it. My best wishes to everyone who is suffering out there.

I am the same but still under 3 months. What have you done other than drugs?
Botox I hear works.

I was helping my husband hang up new curtains in our church. He was 10 feet up on the ladder and I heard him say something and as I looked up the impact drill landed on my face. I feel backwards against the wall and my glasses fell to the floor. After the dizziness subsided I was left with above my left eye and above my lip. As we continued to hang to curtains there was a sudden sharp pain in the top of my head and a metal clanging on the floor. One of the heavy metal brackets to the curtain rod had fallen off the top of the ladder and landed on my head. A sharp shooting pain went straight through my head and cried because it hurt so much. That was two weeks ago and I’ve head horrific headaches every day since. It’s so hard to concentrate on anything when they occur and they wake me up from sleep. Anything seems to trigger them. I need to go to the doctor but I’m afraid to.

Hi i had experience the same too. I am worried about what is already inside my head why it kept on giving me headaches. Hope you can email me. Would like to ask few more questions on it.
Here’s my email jasminah_magao31 @ yahoo .com

Dog ran behind me fell it my neck lower head on the glass table my head hurts and it is very swollen hurts right side

I can't find anything online that explains why. But when I get a headache that meds won't help I've found that hitting the back of my own head with a closed fist, hard (but not aggressivly so) and rythmically helps a lot. It's a temporary fix that seems to only dull the pain for a few minutes, sometimes as much as 10-15 minutes, but it works for me. I wonder why though. I would think it would do the opposite.

I do this also, but it’s at the top-let of my head. It helps for a few minutes. I don’t know why. Came online to find out why and found you.

its all bull im in pain right now the fire in my head prevents me from studying to help myself doctors are useless cowards

My husband hit me very hard at the back side of my skull, right side. It happened on 2md June 2018. Since then I have frequent migraine which is triggered from the part i was hurt. Severe pain reaches to the eyes and eyebrows. No clot was detected in CT Scan, but I know that I am badly affected.
Even after 3 years, I couldn't forget that bad day due to migraine.

Hi I'm only fifteen years old, here's the case. When I'm frustrated, sad, or angry I always tend to bump my head so hard. I can't help it, that's what I always do when I feel sudden burst of emotions and now I feel headaches that will last for than a week but it weakens as the days pass, and I also experience migraines.

i just got my first dose of my vaccine (az) earlier then got into a minor accident on my way home when the tricycle (one mode of transpo in the philippines) i was in crashed into another tricycle parked at the side of the road. it was raining quite heavily and the driver said it was slippery which made him lose balance and crash into the other tricycle. due to the impact of the crash, i hit my head quite hard on the front barrier of the tricycle and split my forehead open, it's only a tiny wound and it didn't bleed much but there was a decent amount of blood. the force of the crash threw me off the tricycle and luckily i just got minor bruises on my knee and left pinkie finger. i only got about two hours of sleep and it's past 5am and i keep getting random bursts of pain all over my head. i wanna get it checked but i don't have enough money to pay for the tests yet. sorry for rambling a lot but any thoughts on this? thank you

When I was kid I use to ride in computer chair and my siblings play with me they use to push the chair when I am in the chair and suddenly the chair fell of and I fell of the and then my forehead got big lump and how many years ago when I'm in mg 6 grade I started to have a headache and when I am in 7 grade I start to have a headache every day and I hate light because it's hurt my eyes and I hate loud sound because it's hurt my head and right now I still have the mark of my lump when what is kind of sick is this

Hi a old style locker fell on and hit the left side of my forehead I didn't go a&e, I keep getting intense headaches mainly on the left side but there is apain thats like lightning that dose left to right. When I bend down I this brings them on but dose happen with out bending down. They can last for 10 minutes or 2 to 3 days and is very uncomfortable, when they have gone my brain almost feels lose in the skill when moving around. I have started taking lions maine mushrooms they help but when I don't take it is much worse I was hit in January 2021 it now June 2021 and I'm getting worried , I struggle to think when they hit and have noticed changes in my behaviour. Any advice would be welcomed

I am Female.
I was subjected to on going head trauma, (regular punching to the back of my head).
Approximately one year later I had on going head pain /sometimes ache on the back of my Cranial.
This carried on for approximately 4 yrs. It has stopped... now.
I am asking for positive advise as to how I can look after my future Brain Health.
Thankyou.

Hello people,

When I was 18, I was attacked by my mums husband.. yes she married an abusive man. When was out drinking, its not the 1st time he's attacked me, I was only 15, the bloke makes me sick! We was out drink and come home and my mum opened her mouth about something so drunk I was trying to verbally defend my self, I was about to go to bed and he threw something to th ride and attacked me, he held me down and punched the crown of my head enough to open cuts, I bleed alot, I managed to get up and run to another house, the police took his side and he said I attacked him, I never, my own mum took his side and picked him up from police station. I was arrested and thrown in a cell, with a bad head, they never did a medical examination. I'm now 35 years old and I get head pain bad what triggers my ptsd, he gave me. My life is ruined, he trys to get in my head and tells me his dad beat him up as a kid and abused him, it's no excuse in my book. This man is violent, he strangled me when I was 15, and police failed me. So here I am with head pain and ptsd triggers and my mum never did anything to help Me but take his side.

Christopher, I am so sorry that all that happened to you and that you were not cherished as a dear son! I have a son Christopher who is just a little younger than you and is so beloved by me! This story breaks my heart so much especially as a mom of a son. I hope you are in a safe place now with people who truly care about you. I had some kind of horrible side effect of a flu and someone slammed a car trunk on my head and I wake up with headaches ugh. I hope that in your life there will be someone who will be like a mum to you and protect you finally. I wish I could take all of those memories and pain away from you. I pray that the Lord Jesus will surround you with His love and close the door to the past and open the door to a better future for you a precious valued young man.

Hello I am so sorry you had to go through that! I had a similar stepfather, hated him. I let my abusive childhood affect my life for years, then I started to realize none of it was my fault. I went for anxiety counseling and medication. It helped me to stop drinking and I just stopped dating abusive men. It might help you if you can do this too! Take care of yourself.

I was wearing these oversized bell-bottom things and I decided that it would be a good idea to RUN in them. I ended up tripping over them and the right side of my head hit a door. It was the loudest thing ever and it woke everyone up. My headaches are horrible and my right eye feels a bit strange. Might go to the doctor soon. Don't run in oversized pants, mostly when they are bell-bottoms. Dumbest thing I've ever done. (I think)

I was leaning towards my door to look out the window without opening my door and I hit the right side of my forehead on the door frame and it hurt. Here I am 3 days later and I have a constant headache in the exact spot and around my eye hurts too especially when I bend my head upside down or clench my eye shut. Not sure if I should wait it out or go to dr

I was reaching for peanut butter in the top shelf. I’m pretty short so I was tip towing and didn’t see the can of dog food on top of the peanut butter. My head ache travels to the other side of my head where it wasn’t hit. I lost time for about 4 hours. We didn’t realize until we woke the next day I didn’t remember much.

I have headache from head injury a year ago and also neck pain back pain and still suffering also i have no a doctor to help me.

hey bro I am facing same problem from neck pain back pain nd forhead ache can i talk to u

I had a head injury on August 2nd 2020 where at work the building I was cleaning a window had opened on my head where the corner of window was impaled in my head, I am still to this day getting head aches and my scar throbs where I had eight stitches, after on month I had a ct scan and results were clear, I've told my doctor I am still getting head aches, but most recently I have been getting mood swing and feeling anxious about almost everything which my doctor just snarled at. Because of covid I feel doctors don't care. Can you advise me more please

Don't be discouraged. I'm sure there's help available, just keep going don't give up. I had a head injury, fractured my skull in a RTC in 2002. It still throbs now, especially when I'm stressed.
Maybe try some pilates, deep breathing, relaxation techniques, they might help. Keep going! :)

I agree. My doctor seems kind of crabby and disinterested in my concerns lately.

I was hit 3 times in my head by my second cousin. After 1 hour i think, i started throwing up inside my classroom. 5 years later, i experienced depression, anxiety, and over thinking and my family doesn't know that because they think that i was okay. That the headache of mine is just a simple migraine. I hope it is not something dangerous 'coz i'm still taking my meds because of my eyes, blood, and bruises (diabetic).

I was rear ended in a car accident 3 years ago and still have on going headaches in the front part of my head. The neurologist told me that my headaches are caused by TBI. How long can these headaches last ? The only real relief I get from the headaches is when I take 1600 mg. Of ibuprofen but I can't take it anymore because of kidney problems. Any suggestions? Thanks

Kratom has been a God given gift. I don't like to think how I would live without it. 9 years of unbearable headaches, multiple blows, head stomped on Lyme's disease and meningitis...it hurts to think, my eyes act erratically after just minutes of reading anything. I usually have to take a nap to get relief. Everyday is a literal struggle to exsist...its a horrific sad truth of my life. I feel like I am going to puke now, just from reading and writing this...ugh!

2 years ago I got hit in the head with a knee at a hockey game. Ever since that day I have had non stop headaches. Almost like migrains. They never go away. How do I get rid of these headaches for good.

Hello: I had a major brain injury at 20 years old and I was recently "one year ago" hit by a car I woke up in the CT scan machine. I am now 50. I have had mild headaches on the top of my skull as if the pain everyday was a mohawk area of pain. Any ideas?

I was punched in the eye 3 weeks ago and still get extremely bad headaches

I have had headaches ever since I fell when I was 7. I am 50 now. I haven't found a doctor or medication that helps my headaches. I get them on the back of the skull and right side of my head and right ear. Any suggestions?

Yes look into piracetam, or aniracetam with choline as a precursor

Hello Doctor 7 months before I fall down from bike and I get my left side upper of ear small scratch. But I don't feel any TBI Symptoms, then after one week, I feel pins and needles pain in my backside of my head and top of the head left side I check with doctor and check MRI scan but not find any abnormalities. But still, my left side head feels wounded pain, pins and needle pain in injured place, ear, cheek, jaw, back and top of the head. The pain is changing in different places. If fall in bet my pillow hurting my left side head, sometimes I feel stiffness in my neck and back and lightheadedness.

Hello I am reaching out for help. My son was shot in the back of his head during a robbery at his work it's been a year and a half now and all of the sudden he is getting major head pains. Keeps us up at night and he is suffering. The pieces of the bullet is still in his head. What kind of doctor should he see. The Nero doc signed off saying he is fine. Clearly he isn't fine. Please advise who we should see

When I was 10 I got kicked in the head by my horse ended up with a fractured skull. I recovered great after having surgery. 15 years later while pregnant with my second child I started getting migraines. I have had them now for 12yrs. I started a new medication in January it was working great I was down to only having them once a month but now I have had a migraine for 3 weeks now it's effecting my work now too. I just started a Medrol dose pack to hopefully break the cycle. I have had a recent MRI neurologist and PCP both say it looks good does show my past skull fracture. Has anyone heard of migraines getting worse as the years go on?

Hi - I started getting severe migraines, went to all sorts of doctors, and on my own realized that it was due to aspartame. Once I cut all diet drinks and yogurt containing aspartame out of my diet, the headaches completely went away. I did try to experiment and as soon as I ingest something containing aspartame I have a migraine within 48 hours. Prior to my early 40’s I never had a problem with it, I guess the body changes. Hope this helps.

Yesterday, My mother took in the Hospital because she fall out of balance in the bathroom. Bumped her head on the floor. Got all test CT scan, blood test and EKG. Its all normal except she's dehydrated and her kidney is elevated. We got home on that day. No medicine given to my mother. Today she feel pain in her head. Why is it there's pain even all test had done is normal? By the way my mother is 81 yrs. Old

My mother fell from stairs. CT showed hemorrhagic contusion 14x11mm which reduced to 11x10mm after four days in CT. For five days she was given pain killer signoflam BDS. From sixth day, doctor stopped. Now, she's suffering from lack of sleep and severe headache at night. For this we give her pain killer every night. But she sleeps only for 3-4 hours. Please advice what to do. Her present medicines:
Stumetil MD one time night
Vertin 8mg- one time
Tryptomer 5mg- BDS
Naxdom 500 (SOS) on headache

Please advice what to do.

Maybe melatonin flash may help her sleep

I obstruct head on road but no symptoms created but almost 6months later area of obstruct on head start little pain like needle on head pls concern something

I fell downstairs last Thursday causing major bruising & swelling on my left eye. I've had a headache since. Will these subside?

I had a fall and head injury two weeks ago and had a headache the first day. It went away but now getting mild headache on side that was hurt. Do I need to see a doctor?

I fellover banged my head 4 weeks ago n now gettin pains in my head

I had a horrible head injury. Never got it checked out though. I don't get headaches like you guys, I get a sudden pulsating pain that starts at pain level 5, and throbs like it's turning on and off like a light switch. (Like someone is flipping a light switch on and off every 2 seconds) Everytime "the light switch" comes back on, it hurts more and more until I'm screaming and crying for it to stop. Then it just stops. Usually lasts 2 minutes or less. For example.
On 5. Off. On 7. Off. On 9. Off.
I can't take it anymore.
The head injury was the back of my head and that's where the pain is, but it spreads out a little.
It only happens when I strain. Like if I'm constipated and strain it hurts, I have to put my head down for it to stop. Or if I'm coughing hard if I'm sick, it hurts. Does anyone know if this is serious. Just don't like doctors or public places. I'm agoraphobic.
I'm traumatized by the pain. Its horrible.

Your symptoms require you to see a doctor. Try to see one or check if there's a physician who can do a home visit. You will probably need a head scan to rule out anything serious. But, it's for the best.

Fell 3 weeks ago now have a pain in right side off my head it's not like head ache it more on my head than in my temples I thought I was ok this has on started this week

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