Excellent breakdown of post-traumatic headache

By Josh Wu. This article was initially published in our Concussion Update newsletter; please consider subscribing.

An article published on Verywell Health provides a well-written overview of the symptoms, causes, diagnosis, and treatment of post-traumatic headaches (PTH). These headaches typically stem from traumatic brain injuries, including concussions, the most common causes of which are falls, automobile injuries, sports injuries, and domestic abuse. However, the physiology behind PTH is still not fully understood. Possible explanations include inflammation of the nervous system, damage to the spine, and dysfunction of pain inhibition neurons.

For a more in-depth explanation of the pathophysiology of PTH, check out Concussion Alliance’s Headaches: Advanced Page. We also recommend our Headaches After Concussion page, which has diagrams and descriptions that assist with identifying different types of PTHs.

PTH symptoms differ among various types of headaches, including migraines and tension headaches. The most common symptoms are dull or mild pain, throbbing headaches, sensitivity to light or sound, dizziness or vertigo, and fatigue. The Verywell Health article also differentiates between acute and chronic symptoms, explaining that symptoms that persist for over two months are considered chronic. 

There are many diagnostic methods for PTHs, as these headaches have so many symptoms that one diagnostic method can’t act as a catch-all. The most common diagnostics are symptom checklists, neuropsychological tests, and vestibular tests. Imaging like MRIs can also be used to screen for bleeding. 

Unfortunately, there are no established PTH treatments. Medications fall into the acute pain management and preventative categories. Pain management medications include NSAIDs, acetaminophen, opioids, and triptans. Preventive medications attempt to prevent headaches from reoccurring or returning; these medications include Tricyclic antidepressants, anticonvulsants, and beta-blockers. Counseling and therapy, relaxation training, lifestyle modifications (getting enough sleep, exercise, and hydration), and physical therapy can also help alleviate symptoms.

In summary, PTHs are defined as a headache that arises within at least seven days of a traumatic brain injury. PTH symptoms vary depending on the person but typically overlap with migraines and tension headache symptoms. Different treatments ranging from painkillers to counseling can help alleviate symptoms. It is essential to reach out to physicians, friends, and family to support you in the path of recovery from PTH.