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 (450)

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.

Hey Lubby,
Your comment really spoke to me. I've been struggling for 16 months now with the ups and downs of post-concussion syndrome. I also feel incredibly frustrated by doctors who can't give me any information, and the lack of direction or guidance about what to do.
Thanks for sharing. I hear you and I'm with you, too.

My son who is 14 was hit in the eye while batting at a baseball All Stars game 6/4/2016 and he still suffers EVERYDAY with terrible headaches and NONE of the meds work at all we have tried everything. So I'm hopeful that he will get some relief. All of his test are good, but he is 90% blind in his right eye but the eye is stable.

Hopeful and need any advise.

This makes me have hope. Thank You! I don't know me after a concussion and these headaches are driving me off the edge after 27 days straight. I won't give up:)

Cheered me up thanks

I have had post concussion headaches for over 14 months. They are severe. They are tension type headaches. I have a history of migraines, but I am on Botox and no longer get migraines. I am unable to take a lot of pain meds because of other health issues. I get my headaches when or after I do too much. Usually after. I hear you. I have started kinesiology and have been trying to get out of the house more to exercise. I have also done vision therapy. As well, I do NUCCA. None of these are making a significant dent.

Thank you so much for this. I seriously have no idea who I was before my concussion and have just hoped what I'm dealing with is normal. Before this I was never upset easily never had a headache in my life; for the last week if I'm up more than a hour or so I start to black out. Your right Drs don't seem to care they say this isn't condusive to a concussion:( But from anything I have read this is exactly what happens from a concussion. How soon did you get back to normal life?

Thank you so much for your encouraging post.

I have severe migraine type pain which wakes me, about 6/7 weeks after hitting my head in a swimming pool. CT scan was clear. I also have a virtual constant low grade headache. But it's the heavy migraine type pain that's the worst for me.

I'm having acupuncture and doing gentle physio advised neck / head movements. The vertigo that started immediately after the accident is still with me but much improved. The worse thing is the head pain, usually one sided and wakes me up. Painkillers dont really help much.

I find acpuncture is helping and also topical ice packs on my face, head, eye, ear area where the main pain is.

I will look into other things on you tube too, take the multi vit B you suggest.

I am also taking curcumin and fish oil which are recommended to heal after a brain injury. And as you say, I sleep a lot more which I read is healing for the brain. And a calm life as much as I can.

Hoping all find some improvement, and a full improvement would be a joy for us all!

Thank you soo much, your article on all that you went through has helped me in so many ways. I fell off my company truck @work broke my wrist & hit the left side of my head didn't think much about hitting my head on the asphalt but for the last 6-7 months it's been a nightmare

err,...I have had chronic headpains since 1993. This due to a blow to my head from a head -on highway auto accident. I lost my profession. The pain is relentless. It is constant,..24 hours a day ,...ALWAYS. The only difference is the intensity of the pains. I have 5 types that come and go,...tho worst is the nerve burning pain. Too many doctors,...too many drugs/therapy. Nothing helps. It looks like its me till I die. I am just happy that after legal battles,...etc,...I have been on disability pension and this has allowed me to survive. I have met many others like myself. It sucks.

My son was in a car accident on Jan. 17, 2017. He was hit from behind suffered whiplash and a concussion. Has had chronic daily headaches since the accident not one day with out a headache. Tried every medicine and therapy available up to Botox nothing helped. Out of desperation never have believed in it but got approved for a Medical Marijuana card. The head pain goes completely away for at least 6 hours at a time till he takes more the only downfall in this is that he gets dizzy from it but he says he can take the dizziness over the head pain any day! On a side note he cant work and has got on disability so he was able to try the MM.

My husband has had headaches since 1980 they are now 12/10 every day since October 2006, nothing works. How is the Marijuana administered? Is it easy to get a Medical card, would appreciate anything you can tell me.

Art, I feel your pain and I’m sick of doctors and trials of every sort. Strong Pain Meds help but can only take a few per day. The rest of the time is just misery...

I’m so sorry to hear u got into a head on collision, but I’m so glad u survived. That right there is a miracle. I would like to ask u about the nerve burning pain u said u get. I have been experiencing that lately. It feels like a tingly burning sensation all over my brain. It’s really concerning me. I hit my head about a week and a half ago.

Thank you so much for posting. I hit my head last Friday on some ice right outside our house. When I fell I fell backward straight on the back of my head. I wound up crawling back to the house and did a 12-hour shift after that. I am a hairdresser that is very busy at the salon most times. The second day I did a four-hour shift and after that became very nauseated. Decided that I needed to go in. They thought it was less than 1% chance that I would have a brain bleed, so I decided to just go home and rest. It is now been a week and I still have a headache and I am not irritated. Very discouraged and emotional and still not feeling myself. I didn't realize how dangerous it was to fall this hard on your head. I expected to maybe take a day and it would feel better. It has not! I feel emotional, hot feverish like, definitely fatigued, and have nausea. It's extremely hard for me to sit but I find myself needing to lay down a lot. Thank you so much for your input. I do feel quite emotional.

Finding myself getting very discouraged. Thank you for letting me know that this takes time it has helped a lot reading your post

Wow Lubby power to you for being so strong. Going on 2 years and have lots of symptoms still. Not being able to function at times. Fatigue headaches light noise too much movement around me makes me worst. In darkness and in the house all the time. I have not so bad in the mornings but feel like shutting down and need to be in a quiet place to sustain some sanity. No one has helped all the doctors want is your money have gotten no relief! Depressed and fatigued and sleeping is all messed up. I go to bed normally around 11:00 pm up and down all night and trouble falling asleep. Although when I hit a wall I shut Down totally. Thanks for reading this. Hopeless

I'm going through now, I actually went backwards again, and I'm just at a stand still. If I had the support I know things would be much better however, right now I do not and that sucks. I understand things will get better soon enough and I am taking things very slowly.

Stay strong god is healing you. Faith and patience.

After 25+ years of constant 24hour headpains,...I do not have hope. sorry

Inspiring story to hear you are getting better. I too have had a similar experience where I spend a lot of time in front of a screen and the continuing concussion symptoms were making things miserable. However, I found some things that DEFINITELY make an impact and have made me feel better with time.

I will recommend a lot of the following, with regular consistency:
- massage therapy on your neck and head
- acupuncture on your neck and head
- static stretching for the neck and head (look on YouTube)
- chiropractic adjustments

which have helped me very nearly fully recover--often, the symptoms remaining from a concussion months after are due to tension in the neck and the spine (possibly being out of alignment due to whiplash or just recovery from the injury). Hope this info helps you. Again, best of luck with your journey back to health.

I got hit in the temple about a month ago and suffered concussion symptoms starting the next day(headache, difficulty sleeping, sensitivity to light and noise, Head pain when concentrating). I have had a mild concussion before so I didn’t go to the doctor and was on winter break so I rested and limited activity for a a week and a half. Now, a month later my symptoms have improved drastically but I still have an almost constant full headache, fatigue, difficulty concentrating, and abnormal sleeping patterns. Should I get an MRI to make sure nothing worse than a headache is happening?

Thank you for this important and relevant information!

My daughter slip and fell flat on her back twice in two weeks last December and hit behind her head, now she's having headaches once there is noises around, now she's feeling dizzy and nausea. What should I do

I think this is a good article and explains a lot Betty

Hello I have a question.

So my grandma tripped on 11/4/17 and hit her head on the right side temple. Went to the ER. Ran CT scan, xrays, ect. All came back good.

Last week she started feeling a pressure in the area. She said it doesn't hurt, but it's annoying. Went to the Dr. He said he thinks it just post concussive tension headache. It's just weird that it came up almost 2 months after.

He said if it continues he will order another CT scan but he doesn't think it's anything serious.

And I over reacting and over thinking? I need some awnsers.

Just wanted to share that our 8yo son collided with another child in a slippery slide! (The other child was coming up as he was going down a tube slide, so couldnt see each other)
More than 8 months on and he is still suffering from headaches.
We have found that Bowen works wondeers for easing his headaches, but he needs it every 2 weeks pretty much. We'd like a longer term solution, so have begun using a blend of Essential Oils tat we used on oir 3yo with consussion a couple weeks ago. For her, the vomiting wouldnt stop with panadol, but relief eas almost immediate with the oils!
If anyone is interested, the oils are Cypress, sandalwood, frankincense. 8 drops each in a 10ml roller topped with a carrier oil like fractiknated coconut oil.

I have gotten 4 concussions from sports, 3 in the past year and I’m only 20 years old. I got my 4th one this past August and I am still getting headaches every day. I powered through the semester at college but it was very very hard because having painful headaches every day is difficult. The only relief I have found is to take amitriptyline and I also have been in physical therapy since October and have been improving. One thing of advice to every one dealing with these headaches is not to let them define you and try to focus on something good that is going to happen that day. I have been reminding myself of this quote, “everyday may not be good, but there is something good in every day”. Hang in there everyone one day it will pass!! Don’t give up hope!!

I got assaulted last year in work, nose was broke and I was severely black and blue for seven weeks. That was a year ago, I have been getting headaches on a daily basis, real bad ones, suffered from memory loss, blackouts depression etc. recently I have been diagnosed with post traumatic headaches and post concussive syndrome, I have been put on amtripilyne, it’s disgusting, makes me feel so sick!!! And my job want to put me back on full duties, I think it’s crazy

my partner got physically hit by a car this past March, he since has gotten headaches that worsen and don’t get better. It’s been 9 months since his accident. And the results stay the same. The doctors keep giving him antidepressants that aren’t even helping him. And my partner doesn’t want to switch doctors even though it’s probably a good idea and I’m just lost at a point. any suggestions?

In 2014 I was beaten up by 3 men with baseball bats. The headaches I still get are demoralizing and I have memory problems too. I just want help but no one is interested. Honestly, if it wasn't for my kids I'd finish it. I've been waiting for god knows how long to see a neurologist and now I'm being told I'm fit for work. Is there anything I can take to relieve the pain? I need to and want to work again but don't feel I can while I'm suffering this.

I'm so sorry this happened to you. Please, see a good Chiropractor. Believe me, they can and will help your problem. There's probably pressure coming from somewhere in your neck, and brain. Chiropractic care can help so many here.

I am sorry that you are going through this. I arrived to this website searching for information to help me. I have struggled all year with continuous mild to moderate headaches, lack of concentration and memory. It has completely affected my life. I was not sure what was going on with me and I finallly realized a month ago that it all started and has continued to a lesser degree since I fell a year ago. It is hard for people to understand the what we describe or experience. When I explain my symptoms, almost everyone replies, oh yeah, stress does that to all of us, oh yeah i suffer from headaches too, oh yeah i don't have a good memory anymore either. It took a lot for me to realize what was wrong with me and to make a big effort that i did not have any of these problems before i fell.
I suggest you to keep looking for help, and keep trying to explain your symptoms even when people try to minimize them, please don't give up, try to pray a bit more and ask God to help you get the help that you need from doctors and others.

Hi Dave, I am sorry to hear of your circumstance. I was wondering if you have considered seeing a chiropractor and/or an acupuncturist to see if you can find relief from your headache? My son got a concussion back in February and he had a very difficult time with post concussion syndrome. He missed so much school because of stroke mimicking migraines that he made no academic progress from Feb-June, and had to have a tutor over the summer. Finally, in July, a light bulb went off and I brought him to a chiropractor. After his second visit, he wasn't experiencing the debilitating migraines and after his 4th visit he was feeling almost 100%. Thankfully he and busted his butt to get back on track academically. I hope that you are able to find some relief, Dave. Best of luck!

Good article. Especially dealing with PTSD. For years now complex PTSD. It's actually considered an anxiety disorder. More education needed on PTSD. It's not just veterans these days but it can happen to anyone living through TRAUMA. Car accidents, abuse violence etc.

I hurt my head with a glass and since then I've been having headaches and memory loss. This happened 5 years ago.

CAR ACCIDENT 2004 SMASHED MY HEAD OTHER SERIOUS INJURIES AFTER HIT AND RUN KILLED MY FRIEND IN THE CAR. LEFT ME TO DIE. I TOOK AMITRIPTYLINE BROUGHT DOWN MY BP TO 89.46 SO WE STOPPED IT. I HAVE HORRIBLE HEADACHES THEY SAY DUE TO PLATYBASIA AND CHIARI MALFORMATION 1 6 HEADACHES SO FAR THIS MONTH ON MAXALT. I REMEMBER THE CAR HITTING US TAKING OFF THEN WENT OUT ALL IS BLANK AFTER THAT. STABLE PLATYBASIA RIGHT NOW GO BACK FEBRUARY 13TH FOR CHECK UP STANFORD

My son 13 at the time was hit in the eye with a baseball, he lost all sight in his right eye June 3 last year and has had a terrible head ache ever since. NOTHING works to ease it please if anyone has suggestions... I am not sure where to go from here!!!! HELP

I have gotten 4 concussions, 3 in the past year and I am still dealing with the 4th one. What I found helped is taking amitriptyline and I also go to physical therapy! If your son is still getting headaches and if you haven’t tried those suggestions I highly recommend them! Hope he gets relief soon!

My son is 12. Same scenario. Desperate to find relief.

a year and a half ago I had an overhanging work lamp come loose on the left side, swing down and hit me on the left side of my head and neck, knocking me down. Since then I have daily migraines, vision problems, dizzy spells, memory problems , panic attacks, and other things I just cant think of at the moment. I get panic attacks when I am at the store or public functions and dont like to go anywhere anymore.

I had a really old chest freezer lid come down on my head. It almost knocked me out. After, I had terrible headaches, nausea and dizziness and neck pain. I went to my chiropractor. She said my neck was out of alignment as was my skull. After just one visit my headaches, nausea and dizziness went away. I go back once in awhile when my neck starts hurting and the symptoms start coming back. I hope this helps you.

My husband of 11 years hit me in the head on my right temple with a broom handle last year... now I'm having random throbbing in the same spot a year later and the internal little knot there has never gone away! You can't see it but you can feel the difference from the right side of my head to the left... don't have insurance right now and today it throbbed when I was just swallowing a bottle of water... so scared that something's internally wrong!

My God! You need to call the police on that husband of yours and get out of that situation NOW!

The other day my bf n I was having a disagreement, n he held my head (I already have neck spasms n back pain) downwards. I was trying to get away, the more I resisted, he held me harder. When I got out of the hold he punched me in the face. I think I knocked out, when I came to I attacked him in defense.
But since than I have terrible headaches, behind my eyeballs hurt, my neck is stiff, when I bend over I feel funny, it hurts to shake my hands. I have no medical insurance so I can't afford to go to a doctor. I am concerned because it doesn't feel right, I can't sit too long.

Vena, please call a domestic violence support network. They will get you the medical treatment you need.

concussion problems. Chronic headache sufferer here. Its not been great waking up and pretending my head is not splitting. This site gave me some answers though on why i may be having this insane headache. It seems there may be no way to cure these headaches.

Exactly what I am experiencing. The emergency room doctor says migraine and acts like the headaches and fall are unrelated. It's a very good thing that the treatment for both is the same.
Im 32 my name david beynon I had a football accident 3 weeks ago I clashed heads with my team mate I took the most on the inpacked I was knocked out for 5 too 10mins but after I came around i had a massive lump on my eye it was like a golf ball but I carried on playing football but a day or two I went to A&E for scans and stuff but broke a cheek bone and had concussion but ever since the accident iv had headache all the time can u give me any advice .
I got a head injury from work 6 months ago and still get headaches nausea vomitting and mood swings that you couldnt believ

Hi just came along this article,I've had 4 concussions,but particularly my 3rd one in 2006 I had a severe concussion and was unconscious for 2 days with amnesia from about a week before and after,it is 2017 ,I still get an abnormal amount of headaches and dizziness,could this some how be related(post concussion trauma)?

I was injured in January 2007, and was not taken to A&E until about an hour afterwards. I was given two painkillers and sent home. I have had all the symptoms of postoncussion syndrome since that day, with my head pain being constant but fluctuating. I had experienced migraines earlier in my life but had eliminated them with diet. Since my injury I have experienced a new kind of migraine - auras and dizziness, whereas I used to just vomit. My condition has worsened and now I also have fibromyalgia and M.E. along with deafness and balance problems from the damage.. It upsets me a lot that doctors pay little to no regard to us; prescribing various medications when's what we really need is a holistic approach to the problem. The books I have dipped into and the research I have seen all point to hormone and nutritional imbalances. I cannot obtain tests for these however, as they are not available on the NHS. I cannot exercise because when I try, the pain becomes unbearable. My weight has gone up because of my sedentary lifestyle and need to rest. I feel like I have bee n abandoned.

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