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 (569)

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 am a professional truck driver who recently had a mild head injury from hitting my head on the underside of a tractor trailer. It was not a bad hit but, was slightly harder than I have done in the past. I didn't think a thing about it until 3 days later when I was set to return back to work on my way in I couldn't see very well and looked like a Kaleidoscope. I knew I didn't have astigmatism as I had recently not even a week prior had an eye examination. I knew something was wrong, later that night I started having speech issues and couldn't remember things. I called the Dr. he diagnosed me with Post Concussion Syndrome, had MRI and CT both negative and clear. It has been 49 days since the incident and still having a constant headache.

I really hate to say this but I wish 'some' doctors or other people feel the same pain their patients are having so they know what they are really going through without having them to explain to them about it lol

I am 30 years old, had 2 concussion back to back. Its been 3 months still I've headache, off balance, nausea im okay with these symptoms but the only thing i am worried is i feel leaking of fluid in my head i went to emergency many times and my family doctor, they didn't help me, i found a private neurology went there she did MRI everything was showing normal and sent me home with tylanol 500mg but this feeling of leaking fluid and the pain kills me its so scary.
Whoever i tell my symptoms of feeling leaking fluid under my scalp they laugh and say i got mental theres not such a thing.
It makes me so sad and more depressed:( even my loved once laugh when i say I feel leaking fluid in my head:( this world is so cruel.
Does anyone have the same symptoms of leaking fluid as me!!

I wrecked a car in 2001 going face first through the wind shield and had to have metal plates in my head and face. I also broke my cervical vertebra 3-5 and c-6. In 2002 I fell backwards off a house at least 12-15 ft and landed directly on my head on concrete. I rebroke my neck. I didnt have a lot of noise but had severe headaches since the car wreck. I flipped an ATV and landed on my head in 2006 which exasterbated my pain in my head and neck. In 2021 I fell
On my ice covered steps and broke three ribs and also reinjured my old wounds. Well there is probably more but those are the major ones. For at least 5 years I’ve had an incredible noise in my head which radiates and pulsates and I also have severe headaches when the noise super loud. I’m just about at my wits end with the extreme
Noise and pain in my neck and back and now in both flanks. I used to love life but anymore it’s difficult to
Tolerate! I sleep horrible because of my blocked sinuses and have sleep
Apnea and snore terrible. Every morning
I get up for work I feel terrible and it’s getting worse. I don’t know what to do. I went to a ear doc and he did an allergy test and I’m allergic to everything. He also
Cat scanned my face and found that my inner frontal bone has deteriorated. With the damage I’ve done I feel lucky to still
Be here but my quality of life isn’t worth it.

Hello everyone, I suffered from a head injury dues to blows that were inflicted on the back and top of my head !! The weapon was a saw off shot gun !! Sometimes I feel pain as if I am being hit. Again !! Sometimes my head gets real tender and can’t be touched !! Movement also can be limited at times ! Post cuncussional syndrome!! Un fortunately mine is for the rest of my life !! My life at times can be interrupted but I try to destress !!

I was about 9 years old when I fell off the monkey bars head first. I'm now almost 36 years old and have been suffering with migraines and other various symptoms every day ever since that day. Ringing in the ears, unsteady balance, light and sound sensitivity..over the past 6 almost 7 years now one of my symptoms has developed into a persistent problem, vertigo. I've undergone intensive therapy and have had all the tests you can think of. I guess I just wanted to say, don't give up. Keep trying to find that doctor that will help you. Keep going for that second, third, fourth opinion until you get the help you deserve. You're worth it.

The exact same thing happened to my daughter and the only thing that helped her was my chiropractor. He’s been practicing for 35 years and travels a lot to learn about different techniques. He said that something was out of place at the top of her head he said the exact terms but I don’t remember. After a few manipulations of her head she was headache free. He put everything back in place.

I can totally relate to the symptoms of light and sound sensitivity. For me, it's already been two years since when I fell on back of my head while snowboarding down the hill. The moment after the concussion, I had to lie down and could not stand up for 5 minutes. No one helped me either - not even the company I went to go with. I think after ten minutes, I finally came down realizing no one was going to help me, and felt like the light was too bright and dizzy.

After ten days of the incident, I took a CT scan at a University Hospital and the doctor seemed absolutely disinterested as he only asked about three questions: one which I remember was when did that happen? I vaped, but rarely drank alcohol and tried to eat healthy as best as I could, even before the concussion. And I tried my best to heal myself, and return back to normal as hard as I could.

Two years after I was searching about this as I'm feeling a bit of pain and change of sensations recently and came across to your comment. I felt hopeless after taking my second CT exam few months ago and when the doctor said he couldn't find anything - until your advice on asking for opinions until I feel like I'm getting the help I deserve.

Thanks so much for this, and hope you'll fully recover until you no longer feel those symptoms. Stay safe

I had a lump dammed drop on my forehead 8weeks ago and iv still got headaches
I didn’t go hospital
But with the headache still here
Should I go and get checked?

I have a concussion since 8-10-22 it was a rather mild hit on the head but to this very moment I've had headaches and neckaches ranging form 3-9 on the 1-10 pain scale, that have never gone away but my L+I doc just gives me some lame touch your nose, do A squat and "well you seem fine to me" like wth I'm in pain not brain dead the best way I can describe it is if you slept wrong and messed you neck up causing a bad headache and neck pain and stiffness BUT IT NEVER GOES AWAY and any exercise makes it worse sometimes my PT helps lessen the pain but sometimes it makes it worse there are days where the pain is so bad I don't want to be conscious. but mri and xray show nothing so I feel like no one believes me and it's so infuriating and disheartening I already had intense depression but this has just been so much.

Did you ever figure out your pain issue and how to cure? I’ve been having same exact issues for 3 years now. July 2020 ruined my life from one simple fall.

This is a long shot, but you could try reading the book “back in control” written by a spine surgeon. I just dove head first into pavement tripping on a curb two days ago. Im keeping my fingers crossed. Good luck to you.

I recently had a car accident. I hit the windshield which broke. I did not seek medical attention. I had bruising around the eyes. That was 4 weeks ago. I am now experiencing sharp pains in my head sporadically.
Should I go to the ER.

I had a severe brain hemmorage about 5 years ago. There were mistakes made within the Icelandic health care system regarding me. I have many disabilities from my two brain injuries so headaches are persistent in my life. Mainly those deep and heavy aches that take over your whole head.

I was hit by a bottle on the back of my head 3 times now i have a continuous headache

I was mugged, beaten, and left for dead 15 years ago. I can remember some of it, some I can’t. I couldn’t walk for six months, and was told I had a minor stroke. MRI found nothing, but I am allergic to the dye they use. I was put on opiates, anti anxiety, and a few other medications. It worked. I was doing ok. I was taken off and tried a plethora of other meds, had seizures and dropped out of college due to pain. I moved with my soon to be husband, got back on my pain control that helped. They reduced it when I was pregnant. I’m done having babies, and now the pain is immense. It’s worse with pressure. Storms and planes are not a fun time. My head actually swells. How do I tell my pcp, I know what works. They put me on gabapentin, and I nearly dropped my daughter.

a week ago , we had experienced minor car accident , it was not that bad though , no blood or broken bones , i only got small bump , went to er because its concerning the head , yet local hospital is quite busy , since its late , decided to go home , no symptoms , yet only dull headache ,i hope this get better :( i wasn't myself these past few days :( been reading your comments , i hope everyone is okay and safe from any serious head injury
, lovelots from philippines

I hit my head on steel like 5 months ago and never went to the doctor. Or filed a work report, it’s tender to touch still and makes my head hurt a little bit should I go to the er or doctors about it? I know this sounds dumb but I try to avoid doctors as much as possible.

I have had multiple head injuries throughout my lifetime. The first one was when I was hit by a car when I was 3-years-old. I have had problems with learning, remembering, and pain. The most recent one happened yesterday, when I hit the back of my head on the side of the couch when I went to lay down. The pain still hasn't subsided. I have been holding a cold lavender rice bag on my head a lot since then. It helps. But the pain still comes back.

I fainted last year a friends house and hit my head on the corner of a wooden block and was rushed to the hospital to get 10 staples. I experienced a lot of head pressure and headaches during the healing, as well as got a diagnosis of what caused the fainting (if you experience this and want to know why, it might be vasovagal syncope, look at symptoms then ask your doctor) but to this day I experience intense migraines. I get headaches often but migraines really ruin my whole day, even week sometimes, to the point I'm nauseous or actually throw up. I get ocular migraines too where I've experienced stroke-like symptoms and vision impairment. I also still have a dull pain in the spot where I got my staples and it feels so tender to the point where if I brush my hair or pull on it, I can feel exactly where the laceration was a year ago. I still don't understand why it's still bothering me and affecting me a whole year later but reading other peoples comments and experiences helped me not feel as weird. I'm 22 and I get so stressed hearing 'stroke-like symptoms' and 'head trauma'.

Hi, I hope it improves and you get some relief soon. I'm 40 and 6 weeks ago I was hit by a bus as a pedestrian and suffered a broken nose and broken rib, I spent the night in hospital and was cleared after tests but weeks on I'm having tingling and electric sensations in my forehead and bad headaches even though there were no signs of anything bad on the scans I had back then. I have to go and see a neurologist in 3 months time and I hope these feeling can ease in time or get better completely, it is scary when you are in pain and there is no clear or obvious sign of what the problem is and doctors look at you as if your mad or just anxious.

I like you how are you now

A car seat fell in my head,, and its place on a high place storage (its up). After I got little it, dizzy and after 2hrs half of my head is aching, specially when I cough, is this dangerous?

I had a quad bike accident in December broke my wrist very badly but still getting dizzy and headaches had a MRI scan came back negative but still don’t feel right the heads are making my life awful don’t no if I hit my head or not but all examinations came back okay

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 hit the back of my head playing soccer in October 2021 . It’s now June 2022 and I have had a dull aching headache 24/7 with not even five minutes of relief did you ever get better?

I’m first and foremost so sorry for your pain you’ve had to endure. I see that was posted in 2021. I am hoping you have found relief in some way since then.
I wanted to just share my story in the shortest way possible, so you know that you are ALWAYS never alone. I’m 39 years old and when I was 15 I was in a car accident ending with 7 skull fractures and loss of hearing in my right ear and a broken tailbone along with other minor breaks. Anyhow, you can do the math.. To this day I still suffer about 98% of my life with a pounding headache. It is a very rare occasion to wake up without one. I’m wanting to share this with you and whoever out there who may stumble upon this that is has caused my husband of 18+ years to want to leave me because he can’t deal with me being in pain everyday of my life. So my big, big point here is make sure you yourself reads up and studies as much information as you can and then when you find an article or anything at all that helps describe your situation, make sure you please share that with your family, partner, children and so on. I don’t wish this upon anyone.
My thoughts are with you and hoping that you are no longer in pain.

Thanks for sharing your story Adam. My injury was in 2016 and I tried every drug and treatment the doctors offered. In the end I found that dealing with them was causing most of my pain. Mild pain killers, antidepressants, and a calm life keep me from passing out when I concentrate. Your solution can only be found by you.

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

I use Botox since my brain injury to reduce the muscle tension caused from clenching in pain. 30-40 needles in the face and head every 3 months helps me to look less scary to my children. I still need to wear a mouthguard when I sleep because I clench my teeth hard enough to chip them.

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.

You need to go to the Doctor right away, you could have something stuck in your head.

You should see your doctor and tell him or her what your symptoms are. You need to g pronto to make sure there is nothing more serious going on. Head injuries are nothing to fool around with.

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've never thought of hitting my head but when I get migraines I put both hands on the sides of my head and squeeze my temples really hard. The pressure makes the throbbing ease up and temporarily eases the nausea I get from the migraines

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.

Same, came here to find out why & whether this kind of percussive pain relief is enough to give someone CTE over a lifetime. Wondering if I'm doing myself more harm than good, lol. I've been doing this since I was a kid. A couple good knocks help for a few minutes!

Post tramatic stress migraine symptoms cure

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.

He may of knocked your neck out. You may want to try a good chiropractor or at least get an xray of your top neck vertebrae. And no I'm not a chiropractor but had a simular experience

I pray you got a divorce.

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